Transition in Smoking Stages and Its Relationship with Family Psychological Function and Perceived Social Support in Adolescents of Tabriz, Iran

Hossein Nemati, Asghar Mohammad poorasl, Hossein Ebrahimi, Shirin B. Atri, Mohammad H. Sahebihagh

Abstract


Background: There is limited information on the relationship between family psychological functions and perceived social support with progress in cigarette smoking stages in adolescents. This study was aimed to determine the relationship between family psychological function and perceived social support through a transition in different stages of cigarette smoking in adolescents of Tabriz, Iran.

Methods: In this study, 4,216 students (14–19 years old) from high schools were selected by multistage cluster sampling method. Initially, we used valid and reliable questionnaires for demographic characteristics, risk factors, Iranian family psychological function, and perceived social support. The smoking status questionnaire was administered twice, with an interval of 6 months. Data were analyzed using univariate and multivariate logistic regression analysis.

Results: Overall, 3,968 students with the mean (standard deviation) age of 15.96 (0.75) years completed the questionnaire in the first phase of the study. The results showed that lower levels of family psychosocial function (P < 0.001) and perceived social support (P < 0.001) in the univariate state were significantly associated with progress in cigarette smoking stages. By controlling the potential confounding factors, the weak and moderate family psychological function compared to the strong function increased the chance of progress in the cigarette smoking stages by almost 11 and 4 times, respectively (P < 0.001). The low and moderate level of perceived social support compared to the high level increased the chance of progress in cigarette smoking stages by almost 7 and 2 times, respectively (P < 0.001).

Conclusions: It is suggested to perform an organized, precise, and operational planning for strengthening the family psychological functions and providing an appropriate social support condition among adolescents to prevent the tendency toward cigarette smoking and its more advanced phases.


Keywords


Adolescent; cigarette smoking; family; psychological function; social support

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References


GBD 2015 Tobacco Collaborators. Smoking prevalence

and attributable disease burden in 195 countries and

territories, 1990‑2015: A systematic analysis from the global

burden of disease study 2015. Lancet (London, England)

;389:1885‑906.

Cantrell J, Bennett M, Mowery P, Xiao H, Rath J, Hair E, et al.

Patterns in first and daily cigarette initiation among youth and

young adults from 2002 to 2015. PLoS One 2018;13:e0200827.

Centers for Disease Control and Prevention [CDC]. Smoking and

Tobacco use. Data and statistics. CDC; 2017. Available from:

https://www.cdc.gov/tobacco/data_statistics/index.htm. [Updated

on 2017 Sep 05].

World Health Organization. WHO report on the global tobacco

epidemic 2017: Monitoring tobacco use and prevention policies.

Available from: https://www.who.int/tobacco/global_report/2017/

en/. [Publication on 2017 Jul 19].

Baška T, Warren CW, Bašková M, Jones NR. Prevalence

of youth cigarette smoking and selected social factors in 25

European countries: Findings from the Global Youth Tobacco eferences

GBD 2015 Tobacco Collaborators. Smoking prevalence

and attributable disease burden in 195 countries and

territories, 1990‑2015: A systematic analysis from the global

burden of disease study 2015. Lancet (London, England)

;389:1885‑906.

Cantrell J, Bennett M, Mowery P, Xiao H, Rath J, Hair E, et al.

Patterns in first and daily cigarette initiation among youth and

young adults from 2002 to 2015. PLoS One 2018;13:e0200827.

Centers for Disease Control and Prevention [CDC]. Smoking and

Tobacco use. Data and statistics. CDC; 2017. Available from:

https://www.cdc.gov/tobacco/data_statistics/index.htm. [Updated

on 2017 Sep 05].

World Health Organization. WHO report on the global tobacco

epidemic 2017: Monitoring tobacco use and prevention policies.

Available from: https://www.who.int/tobacco/global_report/2017/

en/. [Publication on 2017 Jul 19].

Baška T, Warren CW, Bašková M, Jones NR. Prevalence

of youth cigarette smoking and selected social factors in 25

European countries: Findings from the Global Youth Tobacco Survey. Int J Public Health 2009;54:439‑45.

Kapetanovic S, Skoog T, Bohlin M, Gerdner A. Does one

size fit all?‑Linking parenting with adolescent substance use

and adolescent temperament. J Res Adolesc 2019;30(Suppl 2)

‑57.

Hwang JH, Park SW. Age at smoking initiation and subsequent

smoking among Korean adolescent smokers. J Prev Med Public

Health 2014;47:266‑72.

Ho SY, Chen J, Leung LT, Mok HY, Wang L, Wang MP, et al.

Adolescent smoking in hong kong: Prevalence, psychosocial

correlates, and prevention. J Adolesc Health 2019;64:S19‑27.

Zucker RA, Gonzalez R, Feldstein Ewing SW, Paulus MP,

Arroyo J, Fuligni A, et al. Assessment of culture and

environment in the adolescent brain and cognitive development

study: Rationale, description of measures, and early data. Dev

Cogn Neurosci 2018;32:107‑20.

Horner P, Grogan‑Kaylor A, Delva J, Bares CB, Andrade F,

Castillo M. The association of family and peer factors with

tobacco, alcohol, and marijuana use among Chilean adolescents

in neighborhood context. Subst Abuse Rehabil 2011;2:163‑72.

Kimiaee S, Khademian H, Farhadi H, Ghimati A. Develop and

study of preliminary psychometric and validation characteristic

of Iranian family psychological function scale. Quarterly J

Modern Psychol Res 2012;7:145‑82. [Persian].

Miller IW, Ryan CE, Keitner GI, Bishop DS, Epstein NB. The

McMaster approach to families: Theory, assessment, treatment

and research. J Fam Ther 2000;22:168‑89.

Brook JS, Zhang C, Brook DW. Psychosocial factors related to

smoking: The midlife study. Am J Addict 2014;23:423‑28.

Hummel A, Shelton KH, Heron J, Moore L, Bree M. A systematic

review of the relationships between family functioning, pubertal

timing and adolescent substance use. Addiction 2013;108:487‑96.

Kelly SA, Melnyk BM, Jacobson DL, O’Haver JA. Correlates

among healthy lifestyle cognitive beliefs, healthy lifestyle

choices, social support, and healthy behaviors in adolescents:

Implications for behavioral change strategies and future research.

J Pediatr Health Care 2011;25:216‑23.

Wang RAH, Davis OSP, Wootton RE, Mottershaw A,

Haworth CMA. Social support and mental health in late

adolescence are correlated for genetic, as well as environmental,

reasons. Sci Rep 2017;7:13088.

Shruthi P, Niveditha B, Shetty P, Chaitanya K, Khargekar N.

Role of social support in tobacco cessation. Int J Community

Med Public Health 2017;4:3942‑47.

Yang HK, Shin DW, Park JH, Kim SY, Eom CS, Kam S, et al.

The association between perceived social support and continued

smoking in cancer survivors. Jpn J Clin Oncol 2013;43:45‑54.

Mohammadpoorasl A, Nedjat S, Yazdani K, Fakhari A,

Foroushani AR, Fotouhi A. An algorithm of smoking stages

assessment in adolescents: A validation study using the latent

class analysis model. Int J Prev Med 2013;4:1304‑11.

Wellman RJ, Dugas EN, Dutczak H, O’Loughlin EK, Datta GD,

Lauzon B, et al. Predictors of the onset of cigarette smoking:

A systematic review of longitudinal population‑based studies in

youth. Am J Prev Med 2016;51:767‑78.

Ebrahimi H, Sahebihagh MH, Ghofranipour F, Tabrizi JS.

Initiation and continuation of smoking in Iran: A qualitative

content analysis. Int J Community Based Nurs Midwifery

;2:220‑30.

Ayubi E, Sani M, Safiri S, Khedmati Morasae E,

Almasi‑Hashiani A, Nazarzadeh M. Socioeconomic determinants

of inequality in smoking stages: A distributive analysis on

a sample of male high school students. Am J Mens Health

;11:1162‑68.

Anbarlouei M, Sarbakhsh P, Dadashzadeh H, Ghiasi A,

Ataieasl M, Dorosti A, et al. Cigarette and hookah smoking and

their relationship with self‑esteem and communication skills

among high school students. Health Promot Perspect 2018;8:230.

Zimet GD, Dahlem NW, Zimet SG, Farley GK. The

multidimensional scale of perceived social support. J Pers Assess

;52:30‑41.

Bruwer B, Emsley R, Kidd M, Lochner C, Seedat S. Psychometric

properties of the multidimensional scale of perceived social

support in youth. Compr Psychiatry 2008;49:195‑201.

Hill AJ, Boudreau F, Amyot É, Déry D, Godin G. Predicting the

stages of smoking acquisition according to the theory of planned

behavior. J Adolesc Health 1997;21:107‑15.

NHS Digital. Smoking, drinking and drug use among young

people in England‑2016. [Internet]. 2017. Available from:

https://digital.nhs.uk/catalogue/PUB30132. [Publication on

2 Nov].

Ataeiasl M, Sarbakhsh P, Dadashzadeh H, Augner C,

Anbarlouei M, Mohammadpoorasl A. Relationship between

happiness and tobacco smoking among high school students.

Epidemiol Health 2018;40:e2018009.

Strong C, Juon H‑S, Ensminger ME. Effect of adolescent

cigarette smoking on adulthood substance use and abuse: The

mediating role of educational attainment. Subst Use Misuse

;51:141‑54.

Mohammadpoorasl A, Nedjat S, Fakhari A, Yazdani K,

Fotouhi A. Predictors of transition in smoking stages in Iranian

adolescents: Latent transition analysis. East Mediterr Health J

;20:330‑9.

Kremers S, De Vries H, Mudde A, Candel M. Motivational

stages of adolescent smoking initiation: Predictive validity and

predictors of transitions. Addict Behav 2004;29:781‑89.

Weiss JW, Garbanati JA, Tanjasiri SP, Xie B, Palmer PH. Effects

of family functioning and self‑image on adolescent smoking

initiation among Asian‑American subgroups. J Adolesc Health

;39:221‑28.

Wagner KD, Ritt‑Olson A, Chou CP, Pokhrel P, Duan L,

Baezconde‑Garbanati L, et al. Associations between family

structure, family functioning, and substance use among Hispanic/

Latino adolescents. Psychol Addict Behav 2010;24:98‑108.

Mulic M, Ferković V, Kurtić A, Pašić IF. Tobacco, alcohol, drugs

consumption, and perception about the family functioning among

adolescents in Tuzla Canton. J Health Sci 2017;7:146‑57.

Mendel JR, Berg CJ, Windle RC, Windle M. Predicting young

adulthood smoking among adolescent smokers and nonsmokers.

Am J Health Behav 2012;36:542‑54.

Watt RG, Heilmann A, Sabbah W, Newton T, Chandola T,

Aida J, et al. Social relationships and health related behaviors

among older US adults. BMC Public Health 2014;14:533.

Csibi M, Csibi S, Denes M, Ábram Z. Smoking behaviour related

to health status, self esteem, life satisfaction and perceived social

support in an adolescent sample. Acta Medica Transilvanica

;23:1‑5.

Blok DJ, de Vlas SJ, van Empelen P, van Lenthe FJ. The role

of smoking in social networks on smoking cessation and relapse

among adults: A longitudinal study. Prev Med 2017;99:105‑10.

Fagan P, Eisenberg M, Stoddard AM, Frazier L, Sorensen G.

Social influences, social norms, social support, and smoking

behavior among adolescent workers. Am J Health Promot

;15:414‑21.




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