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 and Farzad Hadaegh ()
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Donna Parizadeh: Shahid Beheshti University of Medical Sciences
Seyyed Saeed Moazzeni: Shahid Beheshti University of Medical Sciences
Mitra Hasheminia: Shahid Beheshti University of Medical Sciences
Pegah Khaloo: Shahid Beheshti University of Medical Sciences
Mohammad Ali Mansournia: Tehran University of Medical Sciences
Fereidoun Azizi: Shahid Beheshti University of Medical Sciences
Amir Abbas Momenan: Shahid Beheshti University of Medical Sciences
Farzad Hadaegh: Shahid Beheshti University of Medical Sciences

International Journal of Public Health, 2019, vol. 64, issue 9, No 14, 1345-1354

Abstract: 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 (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s00038-019-01307-z

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