Smoking behavior and its influencing factors in a national-representative sample of Iranian adolescents: CASPIAN study.
OBJECTIVE
To determine the national prevalence of smoking among Iranian youths and its environmental influencing factors.


METHODS
This study was performed in 2003-2004 among 11,966 school students, ages 11-18 years, selected by multi-stage random cluster sampling from 20 provinces in Iran. The participants filled out self-administered anonymous questionnaires.


RESULTS
The prevalence of self-reported cigarette smoking was 14.3%, with a higher prevalence in boys than in girls (18.5% vs. 10.1%, respectively, P < 0.001), and in high school than in middle school students (17.4% vs. 10.6%, respectively, P < 0.001). Overall, 42.2% of smokers were daily smoker, and the rest were occasional smoker. The mean age of the first attempt to smoke was 13.2 +/- 2.5 years with no significant gender difference but was significantly lower in daily than in occasional smokers. The place of the first attempt to smoke was mostly in friend parties (41.6%) and traditional teahouses (23.2%) for boys and the family parties (37.1%) and the traditional teahouses (27.4%) for girls. The higher school level and having a tobacco user at home significantly increased the likelihood of smoking in adolescents, with the highest odds ratio (OR) found for having a smoker sister in girls (OR = 4.5, 95%CI, 2.5, 8.2), and having a smoker brother in boys (OR = 2.4, 95%CI, 2.03, 3.05).


CONCLUSIONS
Smoking is becoming as a major public health threat among Iranian youths. Control measures should be considered not only for cigarette smoking, but also for the socially accepted habit of water pipe use that is revived in traditional teahouses.
Kelishadi
Roya
R
Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, PO Box 81465-1148, Isfahan, Iran. kroya@aap.net
Ardalan
Gelayol
G
Gheiratmand
Riaz
R
Majdzadeh
Reza
R
Delavari
Alireza
A
Heshmat
Ramin
R
Mokhtari
Mohammad Reza
MR
Razaghi
Emran Mohammad
EM
Motaghian
Molouk
M
Ahangar-Nazari
Idin
I
Mahmood-Arabi
Minoo Sadat
MS
Barekati
Hamed
H
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D016009:Chi-Square Distribution; D002648:Child; D016000:Cluster Analysis; D003906:Developing Countries; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires