title: Adolescent Perception on School Environment and Smoking Behavior: Analysis of Isfahan Tobacco use Prevention Program.
abstract: BACKGROUND
  School provides a set of condition which is very important determinant for student smoking behavior. This study aims at exploring the association of the school environment on Iranian middle and high school students smoking.
  
  
  METHODS
  A self-administered anonymous questionnaire was circulated among 5500 randomly selected students with 98.3% response rate. The questionnaire asked on demographic information, student smoking status, and their perception on the school environment. School environment factor was consist of teacher smoking, implementation of smoke-free policy at school, student adherence to this policy, student perception of school personnel attitude and attention on smoking and finally receiving information on smoke-related issues via teachers. Analyses were performed with SPSS software using Chi-square and multiple logistic regression.
  
  
  RESULTS
  Boys with higher level of witness to teachers smoking had higher odds of being smoking (odds ratio [OR] =1.62, 95% confidence interval [CI] =1.17, 2.25); significant relationship was seen between boy's perception regarding school anti-smoking rules and their smoking (OR = 1.40, 98% CI 1.12, 1.75); fewer concern of school personnel on student smoking behavior was correlated to boys smoking behavior (OR = 1.31, 98% CI 1.06-1.63). Among girls, only higher perceived teacher smoking (OR = 2.59, 95% CI = 1.04, 6.44) was associated with their smoking.
  
  
  CONCLUSIONS
  Teachers have a crucial role in student smoking; therefore, they strategies must be taken to persuade the student, school staff, and students to adhere free-smoking policies in and out of school.
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Roohafza
authors.affiliation: Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Kamal
authors.initials: K
authors.lastname: Heidari
authors.affiliation: Provincial Health Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Omidi
authors.affiliation: Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Alinia
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Isfahan Provincial Education and Training Organization, Isfahan, Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Mohammad-Shafiee
authors.affiliation: Welfare Organization, Isfahan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Naji
keywords: Adolescent; perception; school; smoking