title: Exposure to Hookah and Cigarette Smoke in Children and Adolescents According to Their Socio-Economic Status: The CASPIAN-IV Study.
abstract: BACKGROUND
  Exposure to smoking or passive smoking is one of serious health problems especially in the pediatric age group.
  
  
  OBJECTIVE
  To compare the prevalence and determinants of passive smoking in a nationally representative sample of Iranian children and adolescents according to their socioeconomic status (SES).
  
  
  METHODS
  This nationwide study was conducted in 2011 - 2012 among 14880 students aged 6 - 18 years, living in 30 provinces in Iran. Exposure to the smoke of hookah or cigarette was documented by using validated questionnaires. Possible influencing factors were determined and the frequency of passive smoking was compared according to the regional and familial SES.
  
  
  RESULTS
  Participants consisted of 13,486 children and adolescents including 49.2% girls and 75.6% urban inhabitants (90.6% participation rate). The mean age of participants was 12.47 ± 3.36 years. Overall, 43.87% of them (44.07% of boys and 43.66% of girls) were exposed to second hand smoke at home. Exposures to hookah or cigarette smoke at home were respectively reported in 21.46% and 34.49% of participants. The prevalence of passive smoking was lower in children of families with higher SES level, but higher in high SES regions of the country than in low SES ones, and ranged from 39.2% in the region with lowest SES to 49.05% in the highest SES region. Higher education levels of fathers and mothers were significantly associated with lower frequency of passive smoking.
  
  
  CONCLUSIONS
  Exposure to second hand smoke is a major problem among Iranian children and adolescents. Low family SES and low parental education increased the frequency of passive smoking. Appropriate public health education and legislation for smoke free home as well as family-centered counseling should be strengthened.
authors: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors: Roya
authors: R
authors: Kelishadi
authors: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors: Armindokht
authors: A
authors: Shahsanai
authors: Department of Community Medicine, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Mostafa
authors: M
authors: Qorbani
authors: Bureau of Population, Youth and School Health, Ministry of Health and Medical Education, Tehran, IR Iran.
authors: Gelayol
authors: G
authors: Ardalan
authors: Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors: Parinaz
authors: P
authors: Poursafa
authors: Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Ramin
authors: R
authors: Heshmat
authors: Bureau of Population, Youth and School Health, Ministry of Health and Medical Education, Tehran, IR Iran; Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
authors: Mohammad Esmaeil
authors: ME
authors: Motlagh
keywords: Children and Adolescents; Determinants; Passive Smoking; Socio-Economic Status