Hypertension is an emerging disease in children and adolescents resulting in future morbidities. Cigarette smoking is one of the most studied contributing factors in this regard; however, there are contradictory results among different studies. Therefore, the present meta-analysis tends to assess the relationship between passive exposure to cigarette smoke and blood pressure in children and adolescents. Medline, Embase, Scopus, EBSCO, and Web of Sciences were systematically reviewed for observational studies up to May, 2017, in which the relationship between cigarette smoking and hypertension were assessed in children and adolescents. The meta-analysis was performed with a fixed effect or random effects model according to the heterogeneity. Twenty-nine studies were included in present meta-analysis incorporating 192,067 children and adolescents. Active smoking (pooled OR = 0.92; 95% CI: 0.79 to 1.05) or passive exposure to cigarette smoke (pooled OR = 1.01; 95% CI: 0.93 to 1.10) were not associated with developing hypertension in the study population. Despite the fact that active cigarette smoking did not significantly affect absolute level of systolic and diastolic blood pressure, it was shown that passive exposure to cigarette smoke leads to a significant increase in absolute level of systolic blood pressure (pooled coefficient = 0.26; 95% CI: 0.12 to 0.39). Both active and passive cigarette smoking were not associated with developing hypertension in children and adolescents. However, passive cigarette smoke was associated with higher level of systolic blood pressure in children and adolescents.
This cross-sectional survey aimed to provide an overview of tobacco control strategies in the countries of the Eastern Mediterranean Region (EMR). A questionnaire to collate data on implementation of 6 major policies was developed based on the previously published Tobacco Control Scale and using MPOWER measures of the WHO Tobacco Free Initiative and the Tobacco Atlas. Only 3 of the 21 countries scored higher than 50 out of 100: Islamic Republic of Iran (61), Jordan (55) and Egypt (51) More than half of countries scored less than 26. Highest scores were achieved by Afghanistan in cigarette pricing, Oman in smoking bans in public places, Islamic Republic of Iran in budgeting, prohibition of advertisements and health warnings against smoking and Syrian Arab Republic, Tunisia and Kuwait in tobacco cessation programmes. The low mean total score in EMR countries (29.7) compared with European countries (47.2) highlights the need for better future planning and policy-making for tobacco control in the Region.
Background: With the rising prevalence of smoking among university students, coupled with the efficacy of the theory of planned behavior (TPB) in smoking prevention, the current study was conducted to assess the effect of education based on the said theory on adopting smoking preventive behaviors among female university students. Materials and Methods: This experimental interventional study, conducted in 2018, involved 114 female students of Islamic Azad University, Tonekabon Branch (intervention and control groups, each with 57 students). The study data were collected using a demographic questionnaire and the YRBSS 2013, Fishbein, and Ajzen international questionnaire, focusing on the TPB components (intent, attitude, subjective norms, and perceived behavioral control). The data collection occurred in two stages: Before and one month after the intervention. The educational intervention was delivered in three sessions featuring lectures and group discussion methods. The collected data were analyzed by relevant tests using SPSS software, version 21. Results: Before the intervention, no significant relationships were observed between preventive behavior measures and the TPB components in the experimental and control groups (P <0.05). However, one month after the intervention, there was a statistically significant increase in the experimental group’s mean scores of all TPB components and preventive behaviors (P<0.05). Conclusion: Regarding the effectiveness of education based on the theory of planned behavior in reducing the intent to smoke among female students, using this intervention seems to be an appropriate preventive strategy.
Introduction: Following MPOWER9s 2011 report guidelines, a study was conducted that showed Tobacco control planning in the region overall to be at a medium level, with Iran, Egypt and Jordan respectively receiving the highest scores. In the current study, the same analysis was re-done with the same methods using the 2013 report to determine any possible changes. Methods: This is a cross-sectional study that was conducted through 2013 report. We again used the checklist from the original study for this purpose. Five part variables were allocated scores of 0 - 4 and four part variables were given scores of 0 – 3. The maximum score was set at 37. Data entry was done separately by two different people and then compared and confirmed by a third. Scores were then added and rankings were allocated. Results: Among the 22 countries in the region, based on the achieved scores (out of a maximum of 37), Iran, Kuwait, Egypt, Lebanon, Gaza and Jordan were the highest-ranking with scores of 31, 28, 28, 26, 25 and 25, respectively. 14 countries (%63) scored more than 50%, a small improvement from the report 2 years ago. Five countries have seen their scores fall, of which the UAE, with a 7-point decline, had had the sharpest decline. 14 countries received improved scores, with the largest rise belonging to Lebanon with 9 points. Conclusion: It appears there has been a slight improvement overall in tobacco control planning, although the desired levels have yet to be reached and some countries in the region have fared worse. Also there appears to be no improvement in decreasing the prevalence of tobacco consumption.
Background: Smoking is the first preventable cause of mortality in the world. Smoking cessation is affected by various factors like nicotine dependence rate, individual issues and social factors. Measuring the level of exhaled carbon monoxide is a simple noninvasive diagnostic method for determination of smoking status and nicotine dependence; and this study evaluated its correlation with the outcome of smoking cessation. Materials and Methods: In this cross-sectional study, all individuals who had attended the smoking cessation programs in Tehran smoking cessation clinic for 6-sessions during a one- year period were questioned using a questionnaire designed according to the WHO and NRITLD questionnaires. At first, level of exhaled carbon monoxide was measured in all cases and those who quit smoking (no smoking even one puff) after the third treatment session were followed by phone in 1, 3, 6, 12 and 24 month intervals respectively. Results: Three hundred forty- seven cases were questioned in this study out of which, 292 (84.1%) cases were males. At the end of the treatment course, 237 cases (68.3%) successfully quit smoking, 27 cases (7.8%) cut down smoking and 83 cases (23.9%) were excluded from the study due to the exceeded absence from the course. After disregarding the excluded group, the success rate of smoking cessation was calculated to be 89.8%. Measurement of the level of expired carbon monoxide (CO) showed that the exhaled CO level was 20 ppm in 100 (28.8%) cases. The highest rate of success in quitting smoking was observed among those with expired CO level < 11-20 ppm and cigarette consumption less than 30 cigarettes per day (p=0.00). Conclusion: Since cases with high concentration of exhaled carbon monoxide showed lower success rates in quitting smoking, more specific treatment courses along with more precise consultation and follow up are recommended for such
Purpose This study aimed to assess the rate of tobacco consumption among professional athletes in Iran and assessing their knowledge and attitude in this regard. Materials and Methods: A total of 738 athletes from 10 different types of sports were evaluated. Athletes were all members of the priority leagues. After obtaining consent from the Physical Education Organization and coordination with the related federations, athletes were asked to fill out the standard questionnaire. Findings: All understudy subjects were males. The mean age was 28.4±2.7 yrs. A total of 46.7% had high school diploma. In general, 293 subjects (39.7%) were playing individual and 445 (60.3%) were playing team sports. The mean age of initiation of sport in these subjects was reported to be 12.3±4.01 yrs... Sixty four subjects (9%) were current smokers. Twenty one cases (44.7%) were smoking less than 10 cigarettes a day. A total of 26 (66.7%) current smokers stated that smoking helps them in sport competitions. A total of 40 sportsmen from individual sports were current smokers, this rate was 24 (5.5%) among team players (P=0.00). The mean score of knowledge about hazards of smoking was 7.8±0.62 and the mean score of attitude was 26.4±4.1 Conclusion: Rate of smoking among professional athletes is lower than general population average. So participation in organized sports may be a protective factor against tobacco use in people. Percentage of smoker athletes was significantly higher in individual sports compared to team sports. Athletes had good knowledge about hazards of smoking and had a positive attitude in this respect. Further studies are needed to evaluate reasons of cigarette and hookah smoking among athletes.
Cigarette smoking is considered the first preventable cause of death in the world. Social, familial, and personal factors play an important role in prevention or cessation of smoking. Educating the public in order to enhance their knowledge, change their attitude and improve their habits is also effective in this respect. In 2007, the executive protocol of the Comprehensive Law on Smoking Control was compiled in the Ministry of Health and according to the Article 5 of this law pictorial health warning labels had to be applied on cigarette packaging. This study was designed and conducted in 2 phases of before and 9 months after the implementation of this law and evaluated the effect of it on smokers' knowledge, attitude and pattern of smoking.This was a cross-sectional descriptive study conducted to evaluate the effect of cigarette packs' pictorial health warning labels on the knowledge, attitude and smoking pattern of smokers residing in Tehran. After calculating the size of understudy population and estimation of the exclusions, 1731 subjects were randomly selected using the multiphase cluster method from the 22 districts of Tehran. Data were collected using a questionnaire designed according to the standard questionnaire of the World Health Organization (WHO) and International Union Against Tuberculosis and Lung Disease (IUATLD). Qualitative and quantitative value and reliability of the variables including cigarette consumption, knowledge about the law, and pattern of smoking were evaluated in 2 phases and the quality of pictures and their effects on the mentioned variables were assessed in the 2(nd) phase.Before adopting the pictorial warning labels in the first phase of the study, 1731 respondents were evaluated out of which 71.8% were males and 28.2% were females. These cases had an average of 17.6±12.3 years history of smoking. A total of 38% (675 subjects) used Iranian cigarette brands and 39.5% were aware of the implementation of pictorial health warning labels on cigarette packs. In terms of smokers' attitude towards the implementation of this law, they mostly had no opinion about it. A total of 33.3% stated that they may cut down on smoking as the result of this law. Men had a higher percentage of smoking a cigarette first thing in the morning before breakfast and women had a higher rate of consuming foreign cigarette brands (P < 0.001). In the second phase of the study, 1590 cases of the phase 1 subjects participated. Subjects had a significantly higher knowledge about the implementation of pictorial health warning labels on cigarette packs (P < 0.001). Attitude towards this law did not change significantly compared to the first phase although the mean score improved by 0.07%. Enforcement of this law resulted in decreased consumption in 7.6% of the participants. However, the Wilcoxon test did not show any significant difference. In terms of the quality of pictures, 61.6% had no opinion, and 28.7% expressed that the pictures had poor quality. No significant difference was observed between the Iranian or foreign brands in terms of smoking rate after applying the pictorial warning labels.We believed that the smoking rate would decrease after applying the pictorial health warning labels on cigarette packs. However, it did not happen. Also, adopting these labels did not have a significant effect on smokers changing their favorite brand from Iranian to foreign brands or vice versa. Type and quality of pictures require major revision and corrections.
Background: Cigarette smoking is the first preventable death in the world. Presence of a positive attitude towards tobacco use in young adults is one of the effective factors in starting smoking. Since it seems that the age of starting smoking has decreased in our society, it is important to recognize the attitudes towards cigarette smoking in this period of life. Materials and Methods: Therefore, this research was conducted according to WHO questionnaire and Global Youth Tobacco Survey Project (GYTS) and 1119 high school students were chosen randomly from different educational districts of Tehran in the year 2003 and were questioned in this regard. Results: According to the results of this study 28.2% of students (25.2% female and 30.8% male) smoked occasionally and 4.4% of them (1.5% female and 6.06% male) smoked daily. 44.9% of the students believe that smoker students have less friends (than others) and 41.1% believe that smoker students are less comfortable in the parties. 77.7% of the students believe that there is no difference in attractiveness of smoker and non smoker students. 41.1% of the students consider the smoker boy as a “looser” and 38% of them consider the smoker girl as “stupid”. 80.4% of students assume that quitting smoking is very easy. Conclusion: Although the results of this study show that the attitudes of students towards smoking are not positive but this attitude has not prevented them from smoking and more serious action must be taken. Also, there is no significant difference between the attitudes of smoker and non smoker students. (Tanaffos 2004; 3(11): 29-35)
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