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The First Cigarette Smoking Experience and Future Smoking Behaviors Among Adolescents with Different Parental Risk: a Longitudinal Analysis in an Urban Iranian Population

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Abstract

Background

Longitudinal research among Iranian adolescent smoking is limited. The current study aimed to investigate (1) the first smoking experience (FSE) and future smoking behaviors of adolescents with different parental risk factors and (2) the association between age of the FSE and future smoking behaviors over a 12-year follow-up.

Method

Based on Tehran Lipid and Glucose Study (TLGS) database, 1487 adolescents (12–18 years) with complete baseline parental data were recruited. Using two-step cluster analysis, families were classified as either high or low risk; these were based on parental risk factors including age, education, employment, and smoking status. Participants were examined four times in 12 years and their data were used for survival analysis. After exclusion of 24 cases who were smokers at baseline, Cox proportional hazard modeling was used to evaluate the effect of parental clusters on the FSE in 1463 nonsmoking adolescents who completed all prospective follow-ups. Logistic regression analysis was used to examine the effect of the age of FSE on future smoking behaviors.

Results

The mean age of adolescents was 14.63 ± 2.07 years at baseline. Adolescents in the high-risk cluster group were 49% more likely to try smoking for their first time, and 55% more likely to smoke in the future. Compared with girls, boys had 83% higher chance of trying their first cigarette. Moreover, 1-year delay in the FSE resulted in 25% reduction in the probability of smoking in the future.

Conclusion

The findings show that compared with adolescents living in low-risk families, teenagers living in high-risk families are at greater risk of smoking at an earlier age; therefore, this group could benefit from gender- and culture specific preventive interventions.

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References

  1. Organization WH. WHO global report on trends in prevalence of tobacco smoking 2000-2025: World Health Organization. p. 2018.

  2. Organization WH. WHO report on the global tobacco epidemic, 2019: offer help to quit tobacco use: executive summary: executive summary. 2019.

  3. WHO. Global Youth Tobacco Survey-Islamic Republic of Iran. 2018.

  4. Khosravi A, Mansournia MA, Mahmoodi M, Pouyan AA, Holakouie-Naieni K. Estimating the transitional probabilities of smoking stages with cross-sectional data and 10-year projection for smoking behavior in Iranian adolescents. Int J Prev Med. 2016;7:101. https://doi.org/10.4103/2008-7802.188602.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Parizadeh D, Momenan AA, Amouzegar A, Azizi F, Hadaegh F. Tobacco Smoking: findings from 20 years of the Tehran Lipid and Glucose Study. Int J Endocrinol Metab. 2018;16(4 (Suppl)):e84738. https://doi.org/10.5812/ijem.84738.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Harrell JS, Bangdiwala SI, Deng S, Webb JP, Bradley C. Smoking initiation in youth: the roles of gender, race, socioeconomics, and developmental status. J Adolesc Health. 1998;23(5):271–9.

    Article  CAS  PubMed  Google Scholar 

  7. Banzer R, Haring C, Buchheim A, Oehler S, Carli V, Wasserman C, et al. Factors associated with different smoking status in European adolescents: results of the SEYLE study. Eur Child Adolesc Psychiatry. 2017;26(11):1319–29. https://doi.org/10.1007/s00787-017-0980-4.

    Article  PubMed  PubMed Central  Google Scholar 

  8. World Health Organization. WHO report on the global tobacco epidemic ohtqtuesWHO. 2019.

  9. O’Loughlin J, Karp I, Koulis T, Paradis G, Difranza J. Determinants of first puff and daily cigarette smoking in adolescents. Am J Epidemiol. 2009;170(5):585–97. https://doi.org/10.1093/aje/kwp179.

    Article  PubMed  Google Scholar 

  10. Peltzer K. Early smoking initiation and associated factors among in-school male and female adolescents in seven African countries. Afr Health Sci. 2011;11(3):320–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Chang HY, Wu WC, Wu CC, Cheng JY, Hurng BS, Yen LL. The incidence of experimental smoking in school children: an 8-year follow-up of the child and adolescent behaviors in long-term evolution (CABLE) study. BMC Public Health. 2011;11:844. https://doi.org/10.1186/1471-2458-11-844.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Goldade K, Choi K, Bernat DH, Klein EG, Okuyemi KS, Forster J. Multilevel predictors of smoking initiation among adolescents: findings from the Minnesota Adolescent Community Cohort (MACC) study. Prev Med. 2012;54(3–4):242–6. https://doi.org/10.1016/j.ypmed.2011.12.029.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wellman RJ, Dugas EN, Dutczak H, O’Loughlin EK, Datta GD, Lauzon B, et al. Predictors of the onset of cigarette smoking: a systematic review of longitudinal population-based studies in youth. Am J Prev Med. 2016;51(5):767–78. https://doi.org/10.1016/j.amepre.2016.04.003.

    Article  PubMed  Google Scholar 

  14. Tjora T, Hetland J, Aaro LE, Overland S. Distal and proximal family predictors of adolescents’ smoking initiation and development: a longitudinal latent curve model analysis. BMC Public Health. 2011;11:911. https://doi.org/10.1186/1471-2458-11-911.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhao X, White KM, Young RM. Future smoking intentions at critical ages among students in two Chinese high schools. Int J Behav Med. 2019;26(1):91–7. https://doi.org/10.1007/s12529-018-09759-y.

    Article  PubMed  Google Scholar 

  16. Saint Onge JM, Krueger PM. Health lifestyle behaviors among US adults. SSM-population health. 2017;3:89–98.https://doi.org/10.1016/j.ssmph.2016.12.009.

  17. Baumrind D. The influence of parenting style on adolescent competence and substance use. J Early Adolesc. 1991;11(1):56–95. https://doi.org/10.1177/0272431691111004.

    Article  Google Scholar 

  18. Fearnow M, Chassin L, Presson CC, Sherman SJ. Determinants of parental attempts to deter their children’s cigarette smoking. J Appl Dev Psychol. 1998;19(3):453–68.

    Article  Google Scholar 

  19. Chassin L, Presson CC, Rose J, Sherman SJ, Davis MJ, Gonzalez JL. Parenting style and smoking-specific parenting practices as predictors of adolescent smoking onset. J Pediatr Psychol. 2005;30(4):333–44. https://doi.org/10.1093/jpepsy/jsi028.

    Article  PubMed  Google Scholar 

  20. Huang HL, Hsu CC, Peng WD, Yen YY, Chen T, Hu CY, et al. Analysis of influential factors associated with the smoking behavior of aboriginal schoolchildren in remote Taiwanese mountainous areas. J Sch Health. 2012;82(7):318–27. https://doi.org/10.1111/j.1746-1561.2012.00705.x.

    Article  PubMed  Google Scholar 

  21. McKelvey K, Attonito J, Madhivanan P, Yi Q, Mzayek F, Maziak W. Determinants of cigarette smoking initiation in Jordanian schoolchildren: longitudinal analysis. Nicotine Tob Res. 2015;17(5):552–8. https://doi.org/10.1093/ntr/ntu165.

    Article  PubMed  Google Scholar 

  22. Kelishadi R, Mokhtari MR, Tavasoli AA, et al. Determinants of tobacco use among youths in Isfahan, Iran. Int J Public Health. 2007;52(3):173–9.

    Article  PubMed  Google Scholar 

  23. Kelishadi R, Shahsanai A, Qorbani M, Esmaeil Motlagh M, Jari M, Ardalan G, et al. Tobacco use and influencing factors among Iranian children and adolescents at national and subnational levels, according to socioeconomic status: the Caspian-IV Study. Iran Red Crescent Med J. 2016;18(5):e21858. https://doi.org/10.5812/ircmj.21858.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Baheiraei A, Soltani F, Ebadi A, Cheraghi MA, Rahimi FA. Family and peer risk factors as predictors of lifetime tobacco use among Iranian adolescents: gender similarities and differences. Global J Health Sci. 2014;6(4):63–75. https://doi.org/10.5539/gjhs.v6n4p63.

    Article  Google Scholar 

  25. Kelishadi R, Heshmat R, Shahsanai A, Djalalinia S, Motlagh ME, Keikha M, et al. Determinants of tobacco and hookah smoking in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV Study. Iran Red Crescent Med J. 2016;18(8):e31099. https://doi.org/10.5812/ircmj.31099.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Azizi F. Tehran lipid and glucose study. CVD Prev. 2000;3:242–7.

    Google Scholar 

  27. Azizi F, Ghanbarian A, Momenan AA, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and GlucoseStudy phase II. Trials. 2009;10:5. https://doi.org/10.1186/1745-6215-10-5.

  28. Kriska AM, Knowler WC, LaPorte RE, et al. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care. 1990;13(4):401–11.

    Article  CAS  PubMed  Google Scholar 

  29. Delshad M, Ghanbarian A, Ghaleh N, Amirshekari G, Askari S, Azizi F. Reliability and validity of the modifiable activity questionnaire for an Iranian urban adolescent population. Int J Prev Med. 2015;6(1):3. https://doi.org/10.4103/2008-7802.151433.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Group GYTSC. Global Youth Tobacco Survey (GYTS): Core Questionnaire with Optional Questions, Version 1.2. Atlanta, GA: Centers for Disease Control and Prevention, 2014. 2014.

  31. Norušis M. IBM SPSS statistics 19 advanced statistical procedures. New York: Pearson; 2011.

    Google Scholar 

  32. Kleinbaum DG, Klein M. Survival analysis: Springer; 2010.

  33. Soteriades ES, DiFranza JR. Parent’s socioeconomic status, adolescents’ disposable income, and adolescents’ smoking status in Massachusetts. Am J Public Health. 2003;93(7):1155–60.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mathur C, Erickson DJ, Stigler MH, Forster JL, Finnegan JR Jr. Individual and neighborhood socioeconomic status effects on adolescent smoking: a multilevel cohort-sequential latent growth analysis. Am J Public Health. 2013;103(3):543–8. https://doi.org/10.2105/ajph.2012.300830.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ayubi E, Sani M, Safiri S, Khedmati Morasae E, Almasi-Hashiani A, Nazarzadeh M. Socioeconomic determinants of inequality in smoking stages: a distributive analysis on a sample of male high school students. Am J Mens Health. 2017;11(4):1162–8. https://doi.org/10.1177/1557988315585822.

    Article  PubMed  Google Scholar 

  36. Hanson MD, Chen E. Socioeconomic status and health behaviors in adolescence: a review of the literature. J Behav Med. 2007;30(3):263–85. https://doi.org/10.1007/s10865-007-9098-3.

    Article  PubMed  Google Scholar 

  37. Conrad KM, Flay BR, Hill D. Why children start smoking cigarettes: predictors of onset. Br J Addict. 1992;87(12):1711–24.

    Article  CAS  PubMed  Google Scholar 

  38. Paavola M, Vartiainen E, Haukkala A. Smoking from adolescence to adulthood: the effects of parental and own socioeconomic status. Eur J Pub Health. 2004;14(4):417–21. https://doi.org/10.1093/eurpub/14.4.417.

    Article  Google Scholar 

  39. Richter M, Leppin A. Trends in socio-economic differences in tobacco smoking among German schoolchildren, 1994-2002. Eur J Pub Health. 2007;17(6):565–71. https://doi.org/10.1093/eurpub/ckm010.

    Article  Google Scholar 

  40. Liu Y, Wang M, Tynjälä J, Villberg J, Lv Y, Kannas L. Socioeconomic differences in adolescents’ smoking: a comparison between Finland and Beijing, China. BMC Public Health. 2016;16(1):805.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Yanez AM, Leiva A, Estela A, Cukic I. The associations of personality traits and parental education with smoking behaviour among adolescents. PLoS One. 2017;12(3):e0174211. https://doi.org/10.1371/journal.pone.0174211.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Mahabee-Gittens EM, Xiao Y, Gordon JS, Khoury JC. The dynamic role of parental influences in preventing adolescent smoking initiation. Addict Behav. 2013;38(4):1905–11. https://doi.org/10.1016/j.addbeh.2013.01.002.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Kelishadi R, Shahsanai A, Qorbani M, Ardalan G, Poursafa P, Heshmat R, et al. Exposure to hookah and cigarette smoke in children and adolescents according to their socio-economic status: the CASPIAN-IV Study. Iran J Pediatr. 2016;26(4):e3036. https://doi.org/10.5812/ijp.3036.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Barrera DJ. Gender differences in the transmission of smoking from Filipino parents to their offspring: the role of parenting, school climate, and negative emotions. Subst Use Misuse. 2017;52(11):1439–48. https://doi.org/10.1080/10826084.2017.1284237.

    Article  PubMed  Google Scholar 

  45. Fida HR, Abdelmoneim I. Prevalence of smoking among male secondary school students in Jeddah, Saudi Arabia. J Fam Community Med. 2013;20(3):168–72.

    Article  Google Scholar 

  46. Okoli CT, Kodet J. A systematic review of secondhand tobacco smoke exposure and smoking behaviors: smoking status, susceptibility, initiation, dependence, and cessation. Addict Behav. 2015;47:22–32. https://doi.org/10.1016/j.addbeh.2015.03.018.

    Article  PubMed  Google Scholar 

  47. Amiri P, Mohammadzadeh-Naziri K, Abbasi B, Cheraghi L, Jalali-Farahani S, Momenan AA, et al. Smoking habits and incidence of cardiovascular diseases in men and women: findings of a 12 year follow up among an urban Eastern-Mediterranean population. BMC Public Health. 2019;19(1):1042. https://doi.org/10.1186/s12889-019-7390-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Okoli C, Greaves L, Fagyas V. Sex differences in smoking initiation among children and adolescents. Public Health. 2013;127(1):3–10. https://doi.org/10.1016/j.puhe.2012.09.015.

    Article  CAS  PubMed  Google Scholar 

  49. Azagba S, Baskerville NB, Minaker L. A comparison of adolescent smoking initiation measures on predicting future smoking behavior. Prev Med Rep. 2015;2:174–7. https://doi.org/10.1016/j.pmedr.2015.02.015.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Reidpath DD, Davey TM, Kadirvelu A, Soyiri IN, Allotey P. Does one cigarette make an adolescent smoker, and is it influenced by age and age of smoking initiation? Evidence of association from the U.S. Youth Risk Behavior Surveillance System (2011). Prev Med. 2014;59:37–41. https://doi.org/10.1016/j.ypmed.2013.11.011.

    Article  PubMed  Google Scholar 

  51. Davey G, Zhao X. Turning points to becoming a tobacco smoker: smoking initiation and identity change among Chinese youth. Symb Interact. 2019. https://doi.org/10.1002/symb.442.

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Acknowledgments

The authors are grateful to all families who participated in the current study. They would also like to acknowledge Ms. Niloofar Shiva for critical editing of English grammar and syntax of the manuscript.

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Authors and Affiliations

  1. Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Parisa Amiri, Hasti Masihay-Akbar, Sara Jalali-Farahani & Mehrdad Karimi

  2. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

    Mehrdad Karimi

  3. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Amir Abbas Momenan

  4. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fereidoun Azizi

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  1. Parisa Amiri
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Correspondence to Fereidoun Azizi.

Ethics declarations

This study was approved by the research ethics committee of the Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences. All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Prior to data collection, both children and parents were informed about the study procedure and its aims and if the child and parent agreed to participate in the study, parents were asked to sign a written consent form.

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This article does not contain any studies with animals performed by any of the authors.

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Amiri, P., Masihay-Akbar, H., Jalali-Farahani, S. et al. The First Cigarette Smoking Experience and Future Smoking Behaviors Among Adolescents with Different Parental Risk: a Longitudinal Analysis in an Urban Iranian Population. Int.J. Behav. Med. 27, 698–706 (2020). https://doi.org/10.1007/s12529-020-09910-8

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