title: Smoking motivators are different among cigarette and waterpipe smokers: The results of ITUPP.
abstract: The present study explores different drivers of cigarette and water pipe smoking among middle and high school students in Isfahan province. A questionnaire-based cross-sectional study was conducted. Trained staff collected questionnaires and saliva samples for response accuracy evaluation. Prevalence by demographic, parental and educational factors was calculated. Logistic regression was applied to compare behavior drivers of those who purely smoked cigarettes or a waterpipe. Waterpipe smokers were considered as the reference category. This study reported ORs along 95% confidence intervals; 5408 questionnaires were returned. The sample age was 15.37±01.70 on average. The self-reported prevalence of cigarette and waterpipe experimentation was 11.60% (n=624) and 20.70% (n=1,109), respectively; and 5.08% (n=311), 11.06% (n=619) for smokers, and 13.30% (n=711) for the whole sample. Psychological factors were the most important driver for cigarette smoking; bad event happening with odds of 2.38 (95% CI: 1.29-4.39); angriness 2.58 times (95% CI: 1.51-4.43); and distress by 2.49 times (95% CI: 1.42-4.40). Habitual situations were strong predictors of cigarette smoking, but not a predictor of waterpipe smoking, such as smoking after a meal (OR=3.11, 95% CI: 1.67-5.77); and smoking after waking up (OR=2.56, 95% CI: 1.42-4.40). Comprehensive and multifaceted preventive programs must tailor identified factors and increase family's awareness.
authors.affiliation: Tobacco Control Unit, Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: roohafza@crc.mui.ac.ir.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Roohafza
authors.affiliation: Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: Heidari.kamal@yahoo.com.
authors.forename: Kamal
authors.initials: K
authors.lastname: Heidari
authors.affiliation: Epidemiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: alinia_t@yahoo.com.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Alinia
authors.affiliation: Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: omidi@phc.mui.ac.ir.
authors.forename: Razieh
authors.initials: R
authors.lastname: Omidi
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: M_sadeghi@crc.mui.ac.ir.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: Elhamandalib27@yahoo.com.
authors.forename: Elham
authors.initials: E
authors.lastname: Andalib
authors.affiliation: Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: Aliajami99@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Ajami
authors.affiliation: Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: nsarrafzadegan@gmail.com.
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D062789:Tobacco Products
keywords: Adolescence; Cigarette; Initiation; Motive; Smoking; Waterpipe