“It’s beyond the pale to smoke hookah”: perceptions of Iranian adolescents on social unacceptability of hookah smoking

The present study aimed to explore the perceptions of high school students on Social Unacceptability (Arabic/Persian term = Qabahat) of Hookah Smoking (SUoHS). In this qualitative study, 31 student adolescents in Tabriz, Iran, were invited to participate in semi-structured individual interviews and focus group discussions (FGDs). Data were analyzed using interpretative thematic analysis. The unacceptability of hookah smoking was viewed at the “disreputability of hookah smoking and hookah smokers”. The students also explained SUoHS in the “incivility of hookah smoking and smokers in the society”, “disrespectfulness of hookah smokers and their families”, and “the consequences of hookah smoking”. The SUoHS is rooted from the social values and norms within communities. To decrease hookah smoking levels among adolescents, school health nursing interventions should be tailored to bridge the gap between their recognition of SUoHS and subsequent behavior change through creating group dynamics highlighting the domains of social unacceptability of the behavior

Effect of telenursing on quality of life of patients with atrial fibrillation referred to the teaching hospitals in Qazvin

Background: Atrial fibrillation is one of the most common cardiac arrhythmias that occurs 1: 100. Long duration of treatment needs continuous education and follow up that can be achieved by modern nursing techniques such as telenursing. Objective: The aim of this study was to determine the effect of telenursing on quality of life of patients with atrial fibrillation. Methods: This quasi-experimental study was conducted in 100 Patients with atrial fibrillation referred to the teaching hospitals affiliated to Qazvin University of Medical Sciences in 2014. The patients were selected by convenience sampling method and were randomly divided into two groups (intervention and control). In the intervention group, phone calls were made to follow up and to educate patients for 12 weeks. Quality of life was measured before and after the intervention using the SF-36 questionnaire. Data were analyzed using paired T-test, Chi-square test, and T-test. Findings: In the intervention group, the mean quality of life score was significantly increased from 64.88±10.8 before the intervention to 76.14±9.2 after the intervention. In the control group, the mean quality of life score was significantly decreased from 62.6±9.7 before the intervention to 60.05±6.95 after the intervention. Conclusion: With regards to the results, it seems that telenursing can increase the patients’ quality of life and can provide better nursing care. Keywords: Telenursing, Quality of life, Atrial Fibrillatio

Determinants of hookah smoking among men in the coffee houses : an application of socio-ecological approach

Background: Tobacco smoking is the second leading cause of death and is closely linked to fatal diseases. Hookah Smoking (HS) is a traditional way to smoke tobacco, especially in the Eastern Mediterranean region that is constantly rising around the world. This study aimed to evaluate the different levels of personal, interpersonal and social HS in Iranian urban men and determine the most important predictors of the levels through applying the socio-ecological approach (SEA). Methods: This study was conducted in the coffee houses of Hashtrud and Qarah Aghaj counties in East Azerbaijan, Iran. Data collection was conducted from the entire coffee house (n = 18) from April to June 2017. Systematic sampling was employed to recruit 266 men in the coffee house. A valid and reliable instrument was used to investigate the frequency of HS and its determinants based on SEA. The SEA consists of three levels: personal (age, education, employment, income, and perceived severity and sensitivity), interpersonal (perceived reward), and social level (social support) intended to assess HS determinants. Hierarchical regression was used to determine the predictive value of SEA levels and frequency of HS. Results: The mean age of daily hookah smokers (once per day and more than once per day) were (26.8) significantly lower than those (30.4) smokes weekly (once a week or more than once a week). The hierarchical logistic regression model showed that in the first step individual variables significantly predict 25.1% HS. In the second and third level interpersonal and social levels of SEA explained HS 30.1 and 30.8%, respectively. Conclusion: This study found that age, income, education, and perceived reward were all important factors influencing HS among men youth. Application of SEA to determine the factors associated with HS could contribute in the development of a holistic prevention program

Development of a Hookah Smoking Obscenity Measurement Scale for Adolescents

Background: The worldwide trend of hookah use among adolescents is increasing, and literature shows arelationship between obscenity and adolescents’ tendency toward hookah smoking. As there is a lack ofappropriate instruments to measure the obscenity of hookah smoking, in the present study, we aimed todevelop an instrument to measure hookah smoking obscenity among adolescents.Methods: In this methodological study, a sequential exploratory design was used to conduct the study fromFebruary 2017 to July 2018 on adolescents in Tabriz, Iran. In the qualitative phase, we conducted semistructured individual interviews (with 18 students) and a focus group discussion (FGD) (with 13 students) toexplain the concept of obscenity and develop the items of hookah smoking obscenity scale (HSOS). We thenexamined the psychometric properties of the HSOS based on face, content, construct and predictive validitiesas well as internal consistency and repeatability.Findings: The HSOS was developed with 21 items based on the results of qualitative data analysis. Applyingconfirmatory factor analysis (CFA), the χ2/degree of freedom (df) ratio was found to be 3.792 for the fourfactor structure of the questionnaire and the fit indices of this structural model were satisfactory. The valuesof Cronbach’s alpha and the intraclass correlation coefficient (ICC) for the constructs in the HSOS ranged0.81-0.93 and 0.79-0.92, respectively.Conclusion: We found the HSOS with a good level of fit indices, validity, and reliability. The HSOS may beapplied by school healthcare providers and health practitioners to find valid and reliable data on theobscenity of hookah smoking when developing hookah smoking prevention/cessation interventions amongadolescents

Subgroups of lifestyle patterns among hypertension patients : a latent-class analysis

Abstract Background Hypertension remains one of the most important preventable risk factors for diseases and death. Identifying clustered patterns of modifiable lifestyle risk factors for hypertension and demographics factors related to these clustered patterns allows for targeting health prevention interventions. Therefore, this study aims to identify latent classes of hypertensive patients’ lifestyle risk factors based on the clustering of four modifiable lifestyle risk factors: eating, physical activity patterns, smoking habits, and blood pressure control. Methods A total of 750 patients (M age = 65.38 years, SD age = 9.2 years) with diagnosed hypertension in urban and rural primary health care centers in Takab (Iran) were recruited randomly from August 2016 to February 2017. Latent class analysis was performed by using proc. LCA in SAS 9.2. Results Three classes of lifestyle patterns were identified. About 14.4% of hypertensive patients were categorized in a low-risk class (I), 54.6% in an intermediate-risk class (II), and 31% in a high-risk class (III) of lifestyle. A one-year increase in age significantly increases the risk of membership in classes II and III. Similarly, being widowed or divorced increases the risk of membership in classes II and III. Also, having a higher education level decreases the risk of membership in classes II and III. Conclusions This study contributes to the literature on lifestyle behaviors among older adults and provides evidence that there are considerable differences in lifestyle behaviors between subgroups of older adult patients. The three profiles of hypertensive patients’ conditions suggest that because behaviors often occur simultaneously within an individual level, a latent-class approach helps cluster co-occurrence risk behaviors and focuses on interventions targeted to several healthy behaviors among high-risk patients

Prevalence of smoking, alcohol consumption, and drug abuse in Iranian adults: Results of Azar Cohort Study

Background: Substance abuse has significant health impacts on families and society as a whole. We aimed to provide detailed prevalence estimates of substance abuse among the Azar Cohort Study respondents in Tabriz, Iran. Methods: Data on 15006 participants of Azar Cohort Study were analyzed. The variables included tobacco smoking, alcohol use, drug abuse, and socio-demographic characteristics. The prevalence of substance abuse (with a 95% confidence interval) was calculated using the direct standardization method. Results: Overall, 9.3% and 6.2% of the participants were regular and heavy cigarette smokers, respectively. Also, 1.9% and 2.1% of participants reported a history of using illicit drugs and alcohol, respectively. Substance abuse was more prevalent among males than females. Substance abuse varied significantly with age and socioeconomic variables. Conclusion: We identified specific demographic and socioeconomic groups with a higher prevalence of all studied behaviors. Such high-risk groups should be targeted when designing substance abuse prevention programs

Predictors of Transition in Different Stages of Smoking: A Longitudinal Study

Abstract We investigated longitudinally the prevalence of smoking according to three stages of smoking (never smoking, experimenting the smoking, and regular smoking), the rates of transition from one stage to another one, and determinant predictors of transition through these stages of smoking. Of all 10th grade students in Tabriz, 1785 students were randomly selected and assessed twice, with a 12-month interval, with respect to the changes of stage. The predictor variables were measured when the students were in the 10th grade. Logistic regression and principal component analysis were used to analysis data at grade 11. Of 1785 students, 14.3% (CI 95%: 12.3-16.4) and 2.8% (CI 95%: 2.0-4.0) of the never smokers became experimenters and regular smokers, respectively and 16.5% (CI 95%: 12.4-21.7) of the experimenters became regular smokers. Among never smokers, participating in smoker groups (OR = 1.24), having smoker friends (OR = 1.85) and a positive attitude towards smoking (OR = 1.22) predicted experimentation; and participating in smokers groups (OR = 1.35) and a lower socioeconomic class (OR = 0.36) predicted regular smoking. Among experimenters, students having general high risk behaviors (OR = 2.56) and participating in smoker groups (OR = 2.58) were distinguished as those who progressed to regular smoking in follow-up. Programs aimed at smoking prevention and intervention should incorporate plans which focus on predictors of transition through smoking stages, and targeting participation in smoker groups

A Multilevel Latent Class Analysis of Smoking Stages in Adolescents and Its Predictors

Adolescent smoking status were powerful predictors for adult smoking where the most people who started smoking at lower ages continueed to smoke later. The smoking process is complicated and is not limited to smokers and non-smokers, but includes patterns and different stages that need to be identified and evaluated . The main objectives of the current study is to identify stages of smoking in adolescents and to assess factors influencing the patterns of smoking in this population. Using the multistage random sampling, 56 high schools with a total of 205 classrooms were randomly selected. The total number of 4907 high school students in Tabriz, Iran participated in the current study and completed a self-administered questionnaire. Multilevel latent class analysis was used in smoking stage determination. Three stages of smoking were identified non-smokers, moderate, and heavy smokers with prevalence 71.3%, 22.4%, and 6.3%, respectively. In gender specific analysis, such figures were 82.6%, 14.5%, and 2.7% for girls and 77.3%, 15.6%, and 7% for boys, respectively. Age, the grade point average, living with parents, having smoking friends and family, risk taking behaviors, self-injury, attitude and positive thinking about smoking were significantly associated with smoking stages in students. The social-economic status did not have significant association with smoking stage. Using multilevel classification technique that consider the hierarchal construct of data, a more reliable stages of smoking was measured in male and female adolescents

Predictors of Transition in Different Stages of Smoking: A Longitudinal Study

AbstractBackground: We investigated longitudinally the prevalence of smoking according to three stages of smoking (never smoking, experimenting the smoking, and regular smoking), the rates of transition from one stage to another one, and determinant predictors of transition through these stages of smoking.Methods: Of all 10th grade students in Tabriz, 1785 students were randomly selected and assessed twice, with a 12-month interval, with respect to the changes of stage. The predictor variables were measured when the students were in the 10th grade. Logistic regression and principal component analysis were used to analysis data at grade 11.Findings: Of 1785 students, 14.3% (CI 95%: 12.3-16.4) and 2.8% (CI 95%: 2.0-4.0) of the never smokers became experimenters and regular smokers, respectively and 16.5% (CI 95%: 12.4-21.7) of the experimenters became regular smokers. Among never smokers, participating in smoker groups (OR = 1.24), having smoker friends (OR = 1.85) and a positive attitude towards smoking (OR = 1.22) predicted experimentation; and participating in smokers groups (OR = 1.35) and a lower socioeconomic class (OR = 0.36) predicted regular smoking. Among experimenters, students having general high risk behaviors (OR = 2.56) and participating in smoker groups (OR = 2.58) were distinguished as those who progressed to regular smoking in follow-up.Conclusion:Programs aimed at smoking prevention and intervention should incorporate plans which focus on predictors of transition through smoking stages, and targeting participation in smoker groups.Keyword: Smoking, Students, Risk-Taking, Longitudinal Studies, Peer Group, Epidemiology, Prevalence, Risk factor