Factors associated with smoking contemplation and maintenance among Iranian adolescents

Evidence is scarce on which factors contribute to cigarette and waterpipe contemplation and no previous study has examined the factors associated with waterpipe maintenance.

This study aimed to determine the factors associated with cigarette and waterpipe smoking contemplation and maintenance among Iranian adolescents.

Factors including depression, risky behaviour, family conflict, attitude to smoking acceptability and self-efficacy were examined using a questionnaire for 5500 adolescents at the smoking contemplation or maintenance stage.

Students with depression had nearly double the chance [95% confidence interval (CI): 1.41-2.72] of cigarette smoking contemplation. Risk takers had odds of 2.13 (95% CI: 1.51-2.94) and 1.49 (1.22-1.85) of cigarette and waterpipe (hookah) smoking contemplation, respectively. Those facing family conflict had odds of 1.87 (95% CI: 1.38-2.53) and 1.53 for cigarette and waterpipe smoking contemplation, respectively. The contemplation odds for students with more positive attitude to smoking acceptability were 2.12 (95% CI: 1.51-2.97) and 1.72 for cigarette and waterpipe smoking, respectively. Higher self-efficacy was associated with lower cigarette and waterpipe smoking contemplation. Risky behaviour was related to smoking maintenance. A more positive attitude to smoking acceptability was related to higher waterpipe maintenance (odds ratio = 1.57 95% CI: 1.03-2.40).

Depression, attitude to smoking acceptability and risky behaviour are factors associated with smoking contemplation and maintenance.