The role of sociodemographic factors associated with waterpipe smoking among male adolescents in western Iran: A cross-sectional study

The Burden and Correlates of Waterpipe (Hookah) Smoking among Adolescents and Youth: A Systematic Review

BACKGROUND

This systematic review evaluated the available medical literature on the prevalence and trends of waterpipe tobacco smoking among adolescents and youth in jurisdictionally representative populations.

METHODS

PubMed, Embase, and Scopus were searched for relevant studies from inception until 31 December 2022 that reported the burden of waterpipe smoking among adolescents and youth (10-24 years of age). We extracted qualitative data on the demographic characteristics, burden, and correlates of waterpipe smoking (PROSPERO ID: CRD42022310982).

RESULTS

A total of 2,197 articles were screened and 62 were included in the analysis. The majority (29) of the studies was from the United States of America and there were no studies from the south-east Asian region. The prevalence of ever waterpipe smoking among the 10-24 years age group was noted to be 18.16% (95% CI, 18.03-18.29). The prevalence of current (30-day) waterpipe smoking was 6.43% (95% CI, 6.34-6.50). The age of initiation of waterpipe smoking was variable. The prevalence of waterpipe smoking was higher among males, among those who belong to the high- and middle-income groups, and among university students. The common risk factors of waterpipe smoking included cigarette smoking, alcohol, and substance use. Waterpipe smoking resulted in increased susceptibility to the use of conventional forms of tobacco (e.g. smoking) among those who were never smokers.

CONCLUSION

Waterpipe smoking usage was significantly high among adolescents and young adults. Developing regulatory guidelines for water-pipe smoking, surveillance of its use, intervention, and specific policy frameworks may be considered a public health priority.

The Effect of a Web-based Educational Program on Perevention of Hookah Smoking among Adolescent Girls: Application of Theory of Planned Behavior

BACKGROUND

The prevalence of hookah is increasing worldwide and in all age groups, especially among women. Therefore, this study was conducted to determine the effect of web-based educational program in the prevention of hookah smoking among girls in Kermanshah, Iran, using theory of planned behavior (TPB).

METHODS

This study was a randomized controlled trial performed on 110 adolescent girls in Kermanshah City in 2020. Multistage random sampling was used in this study. The data collection tool included a researcher-made questionnaire. Designed intervention was implemented for the intervention group in 5 educational sessions according to analysis of pre-test results. Data were collected 3 months after the end of the training intervention. Data analysis was carried out using SPSS software.

FINDINGS

The presented interventions significantly improved the structures of attitude (P < 0.001), subjective norms (P < 0.001), and intention (P < 0.001) in the intervention group compared with the control group. However, the difference between perceived behavioral control score in the two groups was not significant (P = 0.131). There was also a significant difference in reducing the behavior of hookah smoking between the intervention and control groups after the educational intervention.

CONCLUSION

Using web-based interventions is a good educational strategy for prevention of hookah smoking in adolescent girls.

Prevalence of water pipe smoking and associated risk factors among female adolescents

BACKGROUND

The prevalence of water pipe smoking is increasing among young people, but there are limited data on its use among adolescents in Iran. The aim of this study is to investigate the prevalence of WP smoking and associated risk factors among female adolescents in Western Iran.

MATERIALS AND METHODS

This cross-sectional study was conducted in schools. It included 1302 middle school (48.1%) and high school (51.9%) female students (grades 7-12) recruited through stage random sampling and conducted in 2019 in the western city of Kermanshah, Iran. The data collection tool was a researcher-made questionnaire. Logistic regression analyses and descriptive statistics were executed using SPSS version 22.

RESULTS

The mean (standard deviation) ages of the students and the ages when the participants started WP smoking were 15.22 ± 1.85 and 13.64 (1.64), respectively. Nearly 32.2% had a single experience of WP smoking during their lifetime and 20.4% were current consumers of WP. Most of the subjects smoked WPs at their friends' home (45.8%) and with their friends (47.4%). The significantly important factors that affect WP smoking in these age groups are the father's and mother's occupation, family size, living with others, father's education, having a friend who smokes WPs, friends' encouragement to smoke WP, and being in a family that smoke WPs.

CONCLUSIONS

Considering the increasing popularity of WP among adolescent females and its increasing prevalence, the results showed that Water pipe smoking with friends played a key role in WP smoking among female adolescents. There is a need to design interventional studies to increase people's skills and to design and implement programs to prevent water pipe.

Predictors of shisha smoking among adolescent females in Western Iran in 2019: Using the Prototype-Willingness Model

INTRODUCTION

Given the increasing prevalence of shisha smoking (SS) in adolescent females, it is necessary to determine the factors influencing adolescent’s choice of shisha. This study aimed to determine predictors of shisha smoking among adolescent females in Western Iran based on the Prototype-Willingness Model (PWM).

METHODS

This cross-sectional study was conducted on 1302 adolescent females in Kermanshah city, western Iran, in 2019. The method was multi-stage sampling with a systematic random approach. Data were collected using a questionnaire consisting of sociodemographic questions, history of shisha smoking, and Prototype-Willingness Model structure-based questions. Data were analyzed using SPSS 22 software. Statistical tests included descriptive statistics, Pearson correlation test, and linear and logistic regression analyses.

RESULTS

The prevalence of current consumers of shisha was 20.4%. Attitude and behavioral willingness and subjective norms were the most important predictors of behavioral intentions, whereas subjective norms, attitudes, and prototypes were the most important predictors for behavioral willingness. The results obtained from the logistic regression analysis revealed that both pathways of PWM constructs (behavioral intention OR=1.37; behavioral willingness OR=1.32) were significant predicting factors for shisha smoking among adolescent females.

CONCLUSIONS

Given the efficient role of behavioral willingness and intention for shisha smoking (SS) in adolescent females, it is necessary to consider these structures in designing educational strategies for the prevention of adolescent smoking.

Male students' experiences on predictors of waterpipe smoking reduction: A qualitative study in Iran

INTRODUCTION

In recent years, waterpipe smoking (WPS) has increased among adolescents in Iran. This study aimed to explain the experiences of high school students in Iran on predictors of WPS reduction based on a multi-theory model (MTM) of health behaviour change.

METHODS

This study was a qualitative study of directed content analysis that was conducted in high school male students in Hamadan, Iran, in 2017. In this study, 34 students who had smoked waterpipe (WP) in the last month were recruited through snowball sampling that was continued until data saturation. The data were collected through semi-structured, individual interviews and were then analyzed using directed qualitative content analysis.

RESULTS

The data analysis resulted in the extraction of 104 final codes around the six themes of predetermined MTM constructs consisting of participatory dialogue, behavioural confidence, changes in the physical environment, emotional transformation, practice for change, and changes in the social environment. The findings of this study showed that this model has the potential to explain the behaviour of WPS reduction. The main predictors of reduction in WPS are behavioural confidence, social environment change, and participatory dialogue.

CONCLUSIONS

Findings of the research showed that the belief in an individual’s ability, support from friends and the benefits of WPS reduction are the most important factors in reducing WPS among students. Therefore, it is suggested that comprehensive interventions be developed to improve the individual and social factors that are effective in WPS reduction.

Water Pipe Smoking Reduction in the Male Adolescent Students: An Educational Intervention Using Multi-Theory Model

BACKGROUND

Water pipe smoking (WPS) has increased and is becoming a major leisure pastime among young people in Iran. The aim of this study was to determine of efficacy of an educational intervention based on Multi-Theory Model (MTM) to reduce WPS in the male adolescent students in Iran.

STUDY DESIGN

A randomized controlled trial.

METHODS

Overall, 94 male adolescent students (grades 10, 11) smoked water pipe (WP) in the past month (current WP smokers) were selected, allocated randomly in two groups (47 students in intervention group and 47 students in control group), in two different schools in 2018 in Hamadan City, western Iran. Data were collected utilizing a valid and reliable questionnaire based on MTM constructs and demographic variables. Educational intervention was designed in five 45-min sessions. Two groups were followed-up three-months after completion of intervention. The collected data were analyzed using SPSS 22 software through Chi-square test, independent-sample t-test, paired-samples t-test, and Friedman test.

RESULTS

There were significant differences between the mean score of participatory dialogue, behavioral confidence, emotional transformation and practice for change in the intervention group compared with the control group after the intervention (P<0.001). In addition, significant reductions in the frequency of WPS (from 14.9% to 4.3%) were observed in the intervention group compared to the control group (P<0.001).

CONCLUSION

The developed educational intervention based on MTM constructs was efficacious and can be replicated for effectiveness studies to reduce WPS in the male adolescent students in Iran.