1 Department of Social Medicine, Medical School, Jahrom University of Medical Sciences, Jahrom, Iran.

2 Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

3 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.

4 Department of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

5 Health Education and Health Promotion Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran. AND Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.


Background: Tobacco and hookah smoking is a worldwide problem among adolescents. The present study aimed to determine familial and social factors in predicting the tobacco and hookah smoking among high school students in Jahrom, South of Iran.
Materials and Methods: This cross-sectional study was conducted for assessing the factors affecting hookah and cigarette smoking among high school students during January to April 2015. The participants were 630 high school students (girls=315 and boys=315). The self-administered questionnaire containingstudents’ demographics, parent education, family sizes, tobacco using, tobacco using of the family, hookah smoking, and hookah smoking in the family was used. Multiple logistic regression (MLR) models using the Enter method were fitted to assess the factors that increased or decreased the risk of smoking.
Results: The risk of cigarette smoking was increased with: cigarette smoking by sister (s) or brother (s) (36.8 [95% confidence interval(CI) (1.28-105)]; P=0.03), hookah smoking by mother (6.64 [95%CI (1.28-34.2)]; P=0.02), hookah smoking by father (OR: 5.33 [95%CI:1.88-15.07; P=0.02 ]), hookah smoking by mother (OR: 29.53 [95%CI:10.26-85.01, P<0.001]), hookah smoking by sister (s) or brother (s) (OR: 31.6 [95%CI: 10.71-93.3, P<0.001]), and not consult with parents (4.38 [95%CI (1.48-12.9)]; P=0.007), were significantly related to hookah smoking (P<0.05).
In current study, the prevalence rate of hookah smoking is notable among bothmale (3.8%) and female (1.6%) sexes. Despite the protective role of family in the substance use studies, in the case of hookah smoking, the family provides an opportunity for adolescence to experience hookah smoking.