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International Journal of Public Health

, Volume 64, Issue 9, pp 1345–1354 | Cite as

Sex-specific initiation rates of tobacco smoking and its determinants among adults from a Middle Eastern population: a cohort study

  • Donna Parizadeh
  • Seyyed Saeed Moazzeni
  • Mitra Hasheminia
  • Pegah Khaloo
  • Mohammad Ali Mansournia
  • Fereidoun Azizi
  • Amir Abbas Momenan
  • Farzad HadaeghEmail author
Original article
  • 83 Downloads

Abstract

Objectives

To assess the initiation rate and determinants of tobacco smoking among adults.

Methods

In the Tehran Lipid and Glucose Study, a population-based cohort from Iran, 6101 participants ≥ 18 years old who had never smoked tobacco at baseline (phase II: 2002–2006) were followed until phase VI (2015–2018). Sex-specific initiation rates per 1000 person-years for self-reported tobacco smoking and hazard ratios (HR) for its potential determinants (using Cox proportional hazards models) were calculated.

Results

The age- and sex-adjusted smoking initiation rate was 13.77 [95% confidence interval (CI) 12.59–14.94] per 1000 person-years, of which 78% was attributed to water pipe use. Initiation rate was remarkably higher among men [19.1 (16.9–21.2)] than women [8.3 (7.4–9.2)] and declined in older age-groups. Among both genders, being married was protective [men: HR 0.67 (CI 95% 0.48–0.92); women: 0.58 (0.45–0.74)], while intermediate-level education (compared with high level) [men: 1.61 (1.14–2.26); women: 1.33 (0.95–1.84, p value = 0.092)] and passive smoking [men: 1.76 (1.36–2.28); women: 1.82 (1.42–2.33)] increased the risk. Educational intervention decreased the risk among women [0.74 (0.58–0.94)].

Conclusions

The majority of adult smoking initiators started smoking with water pipe. The initiation rate was remarkably higher in men and younger age-groups. Passive smoking, being single and lower education were risk factors. Educational intervention was protective among women.

Keywords

Tobacco Water pipe Cigarette Smoking Initiation rate Intervention The Tehran Lipid and Glucose Study 

Notes

Acknowledgements

The authors wish to acknowledge Ms. Niloofar Shiva for critical editing of English grammar and syntax of the manuscript. The authors would also like to express their appreciation to the TLGS participants and staff for their kind cooperation.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict interest.

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Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Donna Parizadeh
    • 1
  • Seyyed Saeed Moazzeni
    • 1
  • Mitra Hasheminia
    • 1
  • Pegah Khaloo
    • 1
    • 2
  • Mohammad Ali Mansournia
    • 3
  • Fereidoun Azizi
    • 4
  • Amir Abbas Momenan
    • 1
  • Farzad Hadaegh
    • 1
    Email author
  1. 1.Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
  2. 2.Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr HospitalTehran University of Medical SciencesTehranIran
  3. 3.Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
  4. 4.Endocrine Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran

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