Prevalence and patterns of tobacco, alcohol, and drug use among Iranian adolescents: A meta-analysis of 58 studies

Adolescence is the critical age when adopting high-risk and health-threatening behaviors including smoking, drug and alcohol use is at its peak. Accordingly, this meta-analysis aimed to provide comprehensive nationwide estimates of tobacco, alcohol, and drug use among Iranian adolescents and to compare their habits with other societies. Electronic databases, including PubMed, Medline, Embase, Google scholar and National Persian databases of SID, Magiran, and IranMedex were utilized in identifying relevant articles. The included studies were those having publications, of quantitative estimates and standard errors of the prevalence of cigarette and drug use among 14-19-year-old high school students in Iran from 2000 to 2014. Random-effects meta-analyses were done including a total of 80,588 high school students. The most common drugs among adolescents in Iran were hallucinogens [25.3% (95% CI: 23.9-26.8)], sleeping pills and tranquilizers [25% (95% CI: 24-26.1)], hookah [23.1% (95% CI: 22.2-23.9)], opiates [22% (95% CI: 213-22.7)] and central nervous system (CNS) stimulants [20.1% (95% CI: 19.1-21.1)]. Furthermore, overall estimates for cigarette smoking, alcohol and chewing tobacco/Pan/Nas in the participants were 16.8% (95% CI: 16.4-17.2), 14.7% (95% CI: 142-153) and 10.0% (95% Cl: 8.7-11.4), respectively. However, there was some heterogeneity in the pattern of drug use across the country (P < 0.01). Additionally, the risk of smoking, drinking and drug use by boys was considerably greater than girls. Moreover, data showed a varying trend of drug use over three studied periods of time. In conclusion, a diverse pattern and trend of tobacco smoking, alcohol drinking and drug use among adolescents in Iran was verified. Therefore, preventive and control measures (i.e. education) provided in schools should be compatible with age groups, with emphasis being laid on pattern of use in different parts of the country. (C) 2015 Elsevier Ltd. All rights reserved.