title: Initiation and continuation of smoking in iran: a qualitative content analysis.
abstract: BACKGROUND
  Smoking is the cause for many preventable deaths worldwide. The rate of smoking has not increased in Iran in the past two decades, but its increase among adolescents and young adults is a concern. This study investigates the risk factors of initiation and continuation of smoking in Iran using a qualitative approach.
  
  
  METHODS
  This is a qualitative content analysis study conducted on 12 smokers and 6 non-smokers in 4 selected cities in Iran. Data were collected with deep and semi-structured interviews, verbatim transcription and simultaneously coding. Then, they were analyzed through content analysis.
  
  
  RESULTS
  Three themes and 16 subcategories emerged. The themes were personal inefficacy with 6 subgroups included inadequate information, low age, curiosity, consideration of smoking not as a major problem, wrong beliefs, and making reasons. Family inefficacy with 4 subgroups included poor authority, lack of reaction, existence of stressors, and history of smoking. Vulnerable social environment with 6 subgroups included poverty, social stressors, magnification of smoking, network of cigarette smoking, smoking as a norm and convenience of access.
  
  
  CONCLUSIONS
  Recognition of smoking among children, modification of wrong beliefs about smoking, empowerment of the individuals against smoking from the very childhood, consideration of familial stress and crisis, and ultimately, paying attention to the role of social variables will play a major role in prevention of smoking and encouraging individuals to quit smoking.
authors.affiliation: Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran;
authors.forename: Hossein
authors.initials: H
authors.lastname: Ebrahimi
authors.affiliation: Student Research Committee, Tabriz Health Service Management Research Centre, Department of Community Health Nursing, Faculty of Tabriz Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran;
authors.forename: Mohammad Hasan
authors.initials: MH
authors.lastname: Sahebihagh
authors.affiliation: Department of Health Education, Tarbiat Modarres University, Tehran, Iran;
authors.forename: Fazlollah
authors.initials: F
authors.lastname: Ghofranipour
authors.affiliation: Tabriz Health Service Management Research Centre, Department of Health Service Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Jafar
authors.initials: J
authors.lastname: Sadegh Tabrizi
keywords: Iran; Predisposing Factors; Qualitative Research; Smoking