Transitions between the stages of smoking in Iranian adolescents

Objective. This study examined the prevalence of smoking, the rates of transitions, and predictors of transition through the three stages of smoking. Methods. A total of 1785 high school students in Tabriz (northwest of Iran) were assessed at 2 time points with a 12-month interval in 2005 and 2006, regarding changes in smoking stages. The predictor variables were measured when the students were in the 10th grade. Logistic regression was employed to predict the different smoking stages at grade 11. Results. The results showed that 14.3% (95% confidence interval, 12.3%-16.4%) and 2.8% (2.0%-4.0%) of the never smokers became experimenters and regular smokers, respectively, whereas 16.5% (12.4%-21.7%) of the experimenters became regular smokers. Among never smokers, participation in groups with at least one smoker (odds ratio, 1.24(95% confidence interval, 1.05-1.47)), having smoker friends (1.85 (1.21-2.83)), and a positive attitude toward smoking (1.22(1.02-1.46)) predicted smoking experience. Among the experimenters, those who had general risk behaviors (2.56 (1.12-5.87)) and participated in groups with at least one smoker (2.58 (1.26-5.31)) significantly progressed to becoming a regular smoker at the follow-up. Conclusion. Prevention of smoking in adolescence should begin by focusing on the predictors of transition through smoking stages, especially participating in smoker groups. (C) 2010 Elsevier Inc. All rights reserved.