Smoking status in Iranian male adolescents: A cross-sectional study and a meta-analysis

The present study aimed to estimate the prevalence of smoking status and its associated factors in Iranian adolescents and a meta-analysis of recent cross-sectional studies in order to estimate the corresponding prevalence for all Iranian adolescents.In a cross-sectional study, 1064 male high school students in Zanjan city (northwest of Iran) were recruited. A self-administered questionnaire was used for smoking status and associated factors. Through the meta-analysis, all relevant published studies were reviewed.Almost one-third of adolescents (34.2%, n = 354) have experienced smoking either experimentally (23.4%, n = 242), or regularly (10.8%, n = 112). Multivariate analysis showed that older age (OR = 1.20; 95% CI: 1.05–1.37), risky behaviors (OR = 1.83; 1.25–2.68), Tramadol medication (OR = 2.19; 1.54–3.11), low self-esteem (OR = 1.07; 1.03–1.11), positive attitude toward smoking (OR = 1.15; 1.09–1.21), positive thinking about smoking (OR = 1.07; 1.01–1.14) and having smoker friends (OR = 1.94; 1.36–2.77) were significantly associated with cigarette smoking in adolescents. Meta-analysis results showed that 7% of Iranian adolescents are regular smokers and 27% are experimenters.Increasing prevalence of smoking in Iranian adolescents is a major concern for public health. Controlling risky behaviors and increasing health education are recommended.

► Adolescents’ smoking is going to be a major concern for public heath in Iran.
► Adolescents’ smoking is strongly associated with their peer’s smoking.
► Relatives of experimenter and regular smoker have mild reaction about lighting a cigarette in front of them.
► Tramadol can be considered as a noble gateway for adolescents’ smoking.