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

Journal of School Health

Rezaei

et al. 2022

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BACKGROUND This study assesses the long‐term effectiveness of a lifestyle intervention on cigarette, passive, and hookah smoking in adolescent boys and girls. METHODS One thousand one hundred and fifty‐nine adolescent participants of Tehran Lipid and Glucose Study (TLGS) (2001‐2004) were followed for 12 years. Participants in the intervention area received lifestyle interventions in family, schools, and community settings, with the largest part implemented in schools. After excluding those with missing baseline parental data (n = 66), complete parental data of 1093 adolescents was used for cluster analysis. Families were classified as low‐ and high‐risk. Two hundred and ninety‐six individuals who did not complete intervention/follow‐ups were excluded, GEE was performed on 797 adolescents (369 boys, 192 intervention) to assess the intervention effect on tobacco‐related habits. RESULTS Adolescents' mean baseline age was 15.21 ± 1.95. Those living in high‐risk families were more at risk of cigarette, passive, and hookah smoking. Intervention decreased odds of cigarette and passive smoking by 38% and 57%, respectively. Intervention did not reduce hookah smoking in adolescents. After sex‐specific analysis, the intervention reduced current cigarette smoking by 40% only in boys and passive smoking in both sexes. CONCLUSIONS Targeting lifestyle behaviors in school‐aged adolescents and their families reduces cigarette smoking in boys and protects both sexes from secondhand smoke.

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The Long‐Term Effectiveness of a Multisetting Lifestyle Intervention on Tobacco‐Related Habits in Adolescent Boys and Girls: Tehran Lipid and Glucose Study

Journal of School Health

Rezaei

et al. 2022

Self Cite

“…Two-step cluster analysis, suitable for both continuous and categorical variables, and based on Akaike and Bayesian information criteria, was used to extract the optimal and inherent parental risk groups. The clustering process can be referenced in detail in our previous report (10). Independent samples t-test and chi-square test were used to compare continuous and categorical variables across groups respectively.…”

Section: Discussionmentioning

confidence: 99%

“…In order to obtain better results, school-based programs should be integrated with other initiatives to form comprehensive community programs. Many anti-tobacco programs target families, as parental factors are among several in uential factors in the formation and continuation of smoking behavior in the offspring (10).…”

Section: Introductionmentioning

confidence: 99%

The Long-term Effectiveness of a Community-based Lifestyle Intervention on Tobacco-related Habits in Adolescent Boys and Girls: Tehran Lipid and Glucose Study

Rezaei

et al. 2021

Preprint

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Background: To assess the long-term effectiveness of a community-based intervention on cigarette, passive, and hookah smoking in adolescent boys and girls. Methods: 1159 adolescents who participated in the Tehran Lipid and Glucose Study (TLGS) between 2001 and 2004 were followed for 12 years (every-three-year follow-ups). Participants in the intervention area received lifestyle interventions in the settings of family, schools, and community. After excluding those with missing baseline parental data (n=66), complete parental data of 1093 adolescents was used for cluster analysis, and families were classified as low- and high-risk. Afterward, 296 individuals who did not complete intervention/follow-ups were excluded. The GEE analysis was performed on 797 adolescents (369 boys) to assess the intervention effect on tobacco-related habits; 605 and 192 resided in the control and intervention area, respectively.Results: Mean age of adolescents was 15.21±1.95 years at baseline. Adolescents living in high-risk families were more at risk of cigarette, passive, and hookah smoking. The intervention decreased the odds of cigarette and passive smoking by 38% and 57%, respectively. The intervention was not successful in reducing the risk of hookah smoking in adolescents. After sex-specific analysis, the intervention reduced the risk of current cigarette smoking by 40% only in boys and passive smoking in both sexes.Conclusions: Targeting lifestyle behaviors in adolescents and their families in a community setting reduces cigarette smoking in school-aged boys and protects both sexes from secondhand smoke; findings that could be valuable for designing future health promotion interventions focusing on adolescents smoking.Trial registration: This study is registered at Iran Registry for Clinical Trials (IRCT), a WHO primary registry (http://irct.ir). The registry date is 29/10/2008; (IRCTID: IRCT138705301058N1).

The Cigarette Smoking Initiation and Continuation in Adolescents Undergoing a Long-Term Behavioral Intervention

Nicotine &Amp; Tobacco Research

Cheraghi

et al. 2020

Introduction Targeting adolescents’ smoking reduces its burden on health systems. We investigated the effects of the first multidisciplinary community-based lifestyle intervention in the Eastern-Mediterranean region, on smoking initiation, continuation and risk of current smoking in Iranian adolescents. Methods The current analyses were conducted on 945 non-smoker adolescents (12-18 years) who participated in Phase II of Tehran Lipid and Glucose Study (TLGS) and were examined four times in 12 years. The lifestyle intervention including school-based and public programs was implemented, focusing on all components of healthy lifestyle. Using two-step cluster analysis families were classified as high- and low-risk, based on parental risk factors of adolescents’ smoking. Participants who failed to complete all the follow-ups (n=99) and those with missing smoking data were excluded. Subsequently, 872 adolescents (538 control, 334 intervention) were included in the Cox model on smoking initiation and 674 adolescents (414 control, 260 intervention) were included in the logistic regression on smoking status. Results Mean age of adolescents was 15.08±1.94 years at baseline. The hazard of the smoking initiation was significantly lower in the intervention (HR=0.71, 95% CI: 0.51-0.99; P=0.044) compared to control group. At the end of the 4 th follow-up, intervention reduced the odds of current cigarette smoking by 29%. Within the intervention group, the high-risk cluster was at a 35% lower risk of initiating smoking and had 37% lower odds of becoming a current smoker. However, the intervention could not make a difference in preventing those who initiated smoking from maintaining it during the follow-ups. Conclusions Our results demonstrate that lifestyle modification programs targeting at-risk populations could reduce risk of smoking initiation and current smoking in adolescents in long-term. Implications Experiencing cigarette smoking at the critical period of adolescence could result in adulthood habitual smoking. Therefore, identifying adolescents who are more at risk of smoking initiation and implementing targeted interventions are of great importance in public health. Our findings highlight the long-term effectiveness of a multidisciplinary community-based behavioral intervention on forming smoking behaviors in adolescents. The current intervention was successful in reducing smoking uptake in adolescents living in high-risk families.