Gender-based Differences in Associations between Attitude and Self-esteem with Smoking Behavior among Adolescents: A Secondary Analysis Applying Bayesian Nonparametric Functional Latent Variable Model

Authors

1 Biostatistics Department, International Branch of Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Associate Professor of Biostatistics, Department of Community Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Biostatistics Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

5 Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran AND Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Background: Different patterns of gender-based relationships between attitude toward smoking and self-esteem with smoking behavior have reported. However, such associations may be much more complex than a simply supposed linear relationship. We aimed to propose a method of providing hand details on the total and gender-based scenarios of the relationships between attitude toward smoking and self-esteem with smoking.
Materials and Methods: A secondary analysis conducted on a data set obtained for a cross-sectional study among 4,905 male and female high school students in Tabriz, Iran (2012). We randomly selected 196 classes in a clustering process and invited all the students in the classes to participate in the study; then, investigated the relationship between smoking with attitude and self-esteem, as explanatory variables. We also found the data to fit a nonlinear functional relationship and to be free from normal condition due to applying Bayesian nonparametric functional latent variable model. 
Results: Among all the students, attitude was found as the only variable with conceptual effect on smoking (p<0.05). Among boys, self-esteem showed no conceptual effect on smoking which was in contrast to those found among girls. Smoking among male students with low self-esteem was high, but it was gradually decreasing by rising self-esteem. Among girls, in contrast, smoking was descending by decreasing self-esteem.
Conclusion: The relationships between self-esteem and attitude with smoking may not be necessarily linear. Being at the high levels of self-esteem among boys may lead to the reduced levels of smoking, and among girls may result in the increased level of the behavior.

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