Document Type : Original Article
Authors
Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
BACKGROUND: Recently, the Iranian Ministry of Health estimated about 750,000 deaths are
attributed smoking complications. The aim of this study was to apply the transtheoretical model
(TTM) on general population of Mashhad city to evaluate the stages of change and possible cultural
factors regarding smoking cessation.
METHODS: This descriptive, cross-sectional population-based study was conducted in Mashhad, Iran.
A total number of 562 participants selected by multistage sampling. They were asked about stages of
change for smoking cessation for both hookah and cigarette smoking. Stages of change refer to an
orderly sequence of changes in smoking behavior that people progress through according to the TTM.
Its six stages are as follows: precontemplation (PC) (no intention to quit smoking within 6 months),
contemplation (planning to quit smoking in the following 6 months), preparation (planning to stop
smoking within 1 month), action (quit smoking for <6 months), maintenance (stopped smoking for
6 months or more), and termination (will never smoke again). Data were analyzed using tests such
as Chi-square, Kruskal–Wallis, and logistic regression by SPSS 11.5.
RESULTS: About 18% and 19% of people in this study were regular hookah and cigarette smokers,
respectively. There was significant difference between cigarette smoking and sex (P < 0.001) and
marital status (P = 0.01). There was a statistically significant difference between stages of change
in men and women from the point of cigarette smoking (P < 0.001). Male sex, hookah smoking,
and alcohol abuse were predictors of PC, and age was the only predictor of termination stage for
cigarette smoking. Sex did not have any role in hookah smoking.
CONCLUSION: Targeted education based on gender and marital status warrant attention.
Community-wide education and interventions such as increasing the price of cigarettes are desired.
Keywords
1. Macnee CL, McCabe S. The transtheoretical model of behavior
change and smokers in Southern Appalachia. Nurs Res
2004;53:243-50.
2. Amiri S, Behnezhad S. Smoking as a risk factor for physical
impairment: A systematic review and meta-analysis of 18 cohort
studies. J Addict Dis 2019;38:1-4.
3. Meysamie A, Ghaletaki R, Zhand N, Abbasi M. Cigarette smoking
in Iran. Iran J Public Health 2012;41:1-4.
4. World Health Organization. WHO Report on the Global Tobacco
Epidemic: The MPOWER Package. Geneva: World Health
Organization; 2008.
5. Slama K. Current challenges in tobacco control. Int J Tuberc Lung
Dis 2004;8:1160-72.
6. Mackay J, Eriksen M. The Tobacco Atlas. Geneva: World Health
Organization; 2002.
7. Roohafza H, Sadeghi M, Shahnam M, Shokouh P, Teimori S,
Amirpour A, et al. Social norms of cigarette and hookah smokers
in Iranian universities. ARYA Atheroscler 2013;9:45-50.
8. Akbari ME, Naghavi M, Soori H. Epidemiology of deaths from
injuries in the Islamic Republic of Iran. East Mediterr Health J
2006;12:382-90.
9. Charkazi A, Shahnazi H, Ghourchaei AB, Mirkarimi K.
Smoking behaviors in Iranian male students: An application of
transtheoretical model. J Educ Health Promot 2012;1:22.
10. Prochaska JO, DiClemente CC. Transtheoretical therapy: Toward
a more integrative model of change. Psychother: Theory, Res Pract
1982;19:276.
11. Pantaewan P, Kengganpanich M, Tanasugarn C, Tansakul S,
Termsirikulchai L, Nityasuddhi D. Three intervention levels for
improving smoking behavior among royal Thai army conscripts.
Southeast Asian J Trop Med Public Health 2012;43:1018-24.
12. Roberts B, Gilmore A, Stickley A, Rotman D, Prohoda V,
Haerpfer C, et al. Changes in smoking prevalence in 8 countries
of the former Soviet Union between 2001 and 2010. Am J Public
Health 2012;102:1320-8.
13. Velicer WF, Prochaska JO, Fava JL, Rossi JS, Redding CA,
Laforge RG, et al. Using the transtheoretical model for populationbased approaches to health promotion and disease prevention.
Homeost Health Dis 2012;40: 174-95.
14. Plummer BA, Velicer WF, Redding CA, Prochaska JO,
Rossi JS, Pallonen UE, et al. Stage of change, decisional balance,
and temptations for smoking: Measurement and validation in
a large, school-based population of adolescents. Addict Behav
2001;26:551-71.
15. Andersen S, Keller C. Examination of the transtheoretical model
in current smokers. West J Nurs Res 2002;24:282-94.
16. Razavi Khorasan (Iran): Counties & Cities – Population
Statistics in Maps and Charts. City Population De. Available
from: http://www.citypopulation.de/php/iran-khorasa
nerazavi.php?cityid=091605. [Last accessed on 2020 Mar 24].
17. Hosseinzadeh S, Jahadi TM. The effects of expansion of Mashhad
Metropolise on the natural drainage patterns and increase of
urban floods. GEOGRAPHICAL RESEARCH QUARTERLY
2007;39:145-159.
18. Mousavi Bazzaz M, Zarifian A, Emadzadeh M, Vakili V. Driving
behaviors in Iran: A descriptive study among drivers of Mashhad
City in 2014. Glob J Health Sci 2015;7:39-45.
19. Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the
stages of exercise behavior change. Res Q Exerc Sport 1992;63:60-6.
20. Robert B. Wallace NK, John M. Last Public Health and Preventive
Medicine. 15th ed. United States of America: Mc Graw Hill; 2008.
21. Al-Zalabani A, Kasim K. Prevalence and predictors of adolescents
inverted question mark cigarette smoking in Madinah, Saudi
Arabia: A school-based cross-sectional study. BMC Public Health
2015;21:15-7.
22. Baheiraei A, Hamzehgardeshi Z, Mohammadi MR, Nedjat S,
Mohammadi E. Personal and family factors affecting life time
cigarette smoking among adolescents in Tehran (Rahman, #19):
A community based study. Oman Med J 2013;28:184-90.
23. Ebrahimi H, Sahebihagh MH, Ghofranipour F, Sadegh
Tabrizi J. Initiation and continuation of smoking in Iran:
A qualitative content analysis. Int J Community Based Nurs
Midwifery 2014;2:220-30.
24. Barreto RB, Pincelli MP, Steinwandter R, Silva AP, Manes J, Steidle LJ.
Smoking among patients hospitalized at a university hospital in
the South of Brazil: Prevalence, degree of nicotine dependence, and
motivational stage of change. J Bras Pneumol 2012;38:72-80.
25. Serhier Z, Bendahhou K, Soulimane A, Bennani Othmani M,
Ben Abdelaziz A. Prevalence of smoking in the Maghreb:A systematic review and meta-analysis. Tunis Med 2018;96:545-56.
26. Adeloye D, Auta A, Fawibe A, Gadanya M, Ezeigwe N,
Mpazanje RG, et al. Current prevalence pattern of tobacco smoking
in Nigeria: A systematic review and meta-analysis. BMC Public
Health 2019;19:1719.
27. Moosazadeh M. Meta-analysis of prevalence of smoking in
15-64-year-old population of west of Iran. Int J Prev Med
2013;4:1108-14.
28. Abdollahifard G, Vakili V, Danaei M, Askarian M, Romito L,
Palenik CJ. Are the predictors of hookah smoking differ from
those of cigarette smoking? Report of a population-based study
in Shiraz, Iran, 2010. Int J Prev Med 2013;4:459-66.
29. Boskabady MH, Mahmoudinia M, Eslamizade MJ, Boskabady M,
Shakeri MT, Heydari GR. The prevalence of smoking among
the population in the city of Mashhad (north east of Iran) and
pulmonary function tests among smokers. Pneumonol Alergol
Pol 2011;79:21-5.
30. Hamrah MS, Harun-Or-Rashid M, Hirosawa T, Sakamoto J,
Hashemi H, Emamian MH, et al. Smoking and associated factors
among the population aged 40-64 in Shahroud, Iran. Asian Pac J
Cancer Prev 2013;14:1919-23.
31. Boskabady MH, Farhang L, Mahmoodinia M, Boskabady M,
Heydari GR. Prevalence of water pipe smoking in the city
of Mashhad (North East of Iran) and its effect on respiratory
symptoms and pulmonary function tests. Lung India 2014;31:237-
43.
32. Ghelichkhani P, Yaseri M, Yousefifard M, Baikpour M,
Asady H, Oraii A, et al. The gap of cigarette and hookah smoking
between socioeconomic groups in Iran: Effect of inequalities on
socioeconomic position. Arch Iran Med 2018;21:418-24.
33. Goodwin RD, Grinberg A, Shapiro J, Keith D, McNeil MP, Taha F,
et al. Hookah use among college students: Prevalence, drug use,
and mental health. Drug Alcohol Depend 2014;141:16-20.
34. Grant A, Morrison R, Dockrell MJ. Prevalence of waterpipe
(Shisha, Narghille, Hookah) use among adults in great Britain and
factors associated with waterpipe use: Data from cross-sectional
online surveys in 2012 and 2013. Nicotine Tob Res 2014;16:931-8.
35. Mohammadpoorasl A, Abbasi Ghahramanloo A, Allahverdipour H,
Modaresi Esfeh J. Prevalence of Hookah smoking in relation to
religiosity and familial support in college students of Tabriz,
northwest of Iran. J Res Health Sci 2014;14:268-71.
36. Rahman S, Chang L, Hadgu S, Salinas-Miranda AA, Corvin J.
Prevalence, knowledge, and practices of hookah smoking among
university students, Florida, 2012. Prev Chronic Dis 2014;11:E214.
37. Combrink A, Irwin N, Laudin G, Naidoo K, Plagerson S,
Mathee A. High prevalence of hookah smoking among secondary
school students in a disadvantaged community in Johannesburg.
S Afr Med J 2010;100:297-9.
38. Hoseainrezaee H, Khodabandeh S, Kheradmand A,
Pilehvarzadeh M. Frequency of smoking and specialized
awareness among doctors and nurses of hospitals in Kerman,
Iran. Addict Health 2013;5:51-6.
39. Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, Auf R, et al.
The global epidemiology of waterpipe smoking. Tob Control
2015;24 Suppl 1:i3-12.
40. Heydari G, Yousefifard M, Hosseini M, Ramezankhani A,
Masjedi MR. Cigarette smoking, knowledge, attitude and
prediction of smoking between male students, teachers and
clergymen in Tehran, Iran, 2009. Int J Prev Med 2013;4:557-64.
41. Jamshidi Ardeshiri M, Moosazadeh M, Feizi Masouleh M,
Feizi Masouleh M, Kiani A, Fakhri M. Prevalence of smoking in
15-64 years old population of north of Iran: Meta-analysis of the
results of non-communicable diseases risk factors surveillance
system. Acta Med Iran 2013;51:494-500.
42. Moosazadeh M, Ziaaddini H, Mirzazadeh A, Ashrafi-Asgarabad A,
Haghdoost AA. Meta-analysis of smoking prevalence in Iran.
Addict Health 2013;5:140-53.
43. Bui TV, Blizzard L, Luong KN, Truong Nle V, Tran BQ, Ha ST, et al.
Declining prevalence of tobacco smoking in Vietnam. Nicotine
Tob Res 2015;17:831-8.
44. Kaleta D, Usidame B, Dziankowska-Zaborszczyk E,
Makowiec-Dąbrowska T, Leinsalu M. Prevalence and factors
associated with hardcore smoking in Poland: Findings from the
Global Adult Tobacco Survey (2009-2010). BMC Public Health
2014;14:583.
45. Sreeramareddy CT, Pradhan PM, Mir IA, Sin S. Smoking and
smokeless tobacco use in nine South and Southeast Asian
countries: Prevalence estimates and social determinants from
demographic and health surveys. Popul Health Metr 2014;12:22.
46. Thakur JS, Prinja S, Bhatnagar N, Rana S, Sinha DN. Socioeconomic
inequality in the prevalence of smoking and smokeless tobacco
use in India. Asian Pac J Cancer Prev 2013;14:6965-9.
47. Han J, Chen X. A meta-analysis of cigarette smoking prevalence
among adolescents in China: 1981-2010. Int J Environ Res Public
Health 2015;12:4617-30.
48. Ji CY, Chen TJ, Song Y, Hu PZ, Xing Y, Zhang L. Smoking status
of high school and college students in China. Chin J Sch Health
2009;30:109-11.
49. Niu L, Liu Y, Luo D, Xiao S. Current smoking behavior among
medical students in mainland China: A systematic review and
meta-analysis. Asia Pac J Public Health 2018;30:610-23.
50. Agrawal M, Jain S, Maitin N, Gupta T, Maitin S. Prevalence and
predictors of tobacco use among general public of Gorakhpur
district, India. J Oral Biol Craniofac Res 2015;5:16-20.
51. Coban FR, Kunst AE, Van Stralen MM, Richter M, Rathmann K,
Perelman J, et al. Nicotine dependence among adolescents in
the European Union: How many and who are affected? J Public
Health (Oxf) 2019;41:447-55.
52. Mohammad-Alizadeh-Charandabi S, Mirghafourvand M,
Tavananezhad N, Karkhaneh M. Prevalence of cigarette and water
pipe smoking and their predictors among Iranian adolescents. Int
J Adolesc Med Health 2015;27:291-8.
53. Etter JF. Associations between smoking prevalence, stages of
change, cigarette consumption, and quit attempts across the
United States. Prev Med 2004;38:369-73.
54. Linde BD, Ebbert JO, Pasker CK, Wayne Talcott G, Schroeder DR,
Hanson AC, et al. Prevalence and predictors of hookah use in US
Air Force military recruits. Addict Behav 2015;47:5-10.
55. Hopkins DP. The guide to community preventive services:
Tobacco use prevention and control: Reviews recommendations,
and expert commentary. Am J Prev Med 2001;20:1-88.
56. Owusu D, Quinn M, Wang K, Williams F, Mamudu HM.
Smokefree home rules and cigarette smoking intensity among
smokers in different stages of smoking cessation from 20 lowand-middle income countries. Prev Med 2020;132:106000.
57. Seangpraw K, Tonchoy P. Factors related intention to smoking
cessation among Thai people who joined quit smoking project for
the king: A cross-sectional study of Northern Thailand. J Ayub
Med Coll Abbottabad 2019;31:512-6.
58. Ahluwalia IB, Smith T, Arrazola RA, Palipudi KM, Garcia de
Quevedo I, Prasad VM, et al. Current tobacco smoking, quit
attempts, and knowledge about smoking risks among persons
aged ≥15 years - global adult tobacco survey, 28 countries,
2008-2016. MMWR Morb Mortal Wkly Rep 2018;67:1072-6.
change and smokers in Southern Appalachia. Nurs Res
2004;53:243-50.
2. Amiri S, Behnezhad S. Smoking as a risk factor for physical
impairment: A systematic review and meta-analysis of 18 cohort
studies. J Addict Dis 2019;38:1-4.
3. Meysamie A, Ghaletaki R, Zhand N, Abbasi M. Cigarette smoking
in Iran. Iran J Public Health 2012;41:1-4.
4. World Health Organization. WHO Report on the Global Tobacco
Epidemic: The MPOWER Package. Geneva: World Health
Organization; 2008.
5. Slama K. Current challenges in tobacco control. Int J Tuberc Lung
Dis 2004;8:1160-72.
6. Mackay J, Eriksen M. The Tobacco Atlas. Geneva: World Health
Organization; 2002.
7. Roohafza H, Sadeghi M, Shahnam M, Shokouh P, Teimori S,
Amirpour A, et al. Social norms of cigarette and hookah smokers
in Iranian universities. ARYA Atheroscler 2013;9:45-50.
8. Akbari ME, Naghavi M, Soori H. Epidemiology of deaths from
injuries in the Islamic Republic of Iran. East Mediterr Health J
2006;12:382-90.
9. Charkazi A, Shahnazi H, Ghourchaei AB, Mirkarimi K.
Smoking behaviors in Iranian male students: An application of
transtheoretical model. J Educ Health Promot 2012;1:22.
10. Prochaska JO, DiClemente CC. Transtheoretical therapy: Toward
a more integrative model of change. Psychother: Theory, Res Pract
1982;19:276.
11. Pantaewan P, Kengganpanich M, Tanasugarn C, Tansakul S,
Termsirikulchai L, Nityasuddhi D. Three intervention levels for
improving smoking behavior among royal Thai army conscripts.
Southeast Asian J Trop Med Public Health 2012;43:1018-24.
12. Roberts B, Gilmore A, Stickley A, Rotman D, Prohoda V,
Haerpfer C, et al. Changes in smoking prevalence in 8 countries
of the former Soviet Union between 2001 and 2010. Am J Public
Health 2012;102:1320-8.
13. Velicer WF, Prochaska JO, Fava JL, Rossi JS, Redding CA,
Laforge RG, et al. Using the transtheoretical model for populationbased approaches to health promotion and disease prevention.
Homeost Health Dis 2012;40: 174-95.
14. Plummer BA, Velicer WF, Redding CA, Prochaska JO,
Rossi JS, Pallonen UE, et al. Stage of change, decisional balance,
and temptations for smoking: Measurement and validation in
a large, school-based population of adolescents. Addict Behav
2001;26:551-71.
15. Andersen S, Keller C. Examination of the transtheoretical model
in current smokers. West J Nurs Res 2002;24:282-94.
16. Razavi Khorasan (Iran): Counties & Cities – Population
Statistics in Maps and Charts. City Population De. Available
from: http://www.citypopulation.de/php/iran-khorasa
nerazavi.php?cityid=091605. [Last accessed on 2020 Mar 24].
17. Hosseinzadeh S, Jahadi TM. The effects of expansion of Mashhad
Metropolise on the natural drainage patterns and increase of
urban floods. GEOGRAPHICAL RESEARCH QUARTERLY
2007;39:145-159.
18. Mousavi Bazzaz M, Zarifian A, Emadzadeh M, Vakili V. Driving
behaviors in Iran: A descriptive study among drivers of Mashhad
City in 2014. Glob J Health Sci 2015;7:39-45.
19. Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the
stages of exercise behavior change. Res Q Exerc Sport 1992;63:60-6.
20. Robert B. Wallace NK, John M. Last Public Health and Preventive
Medicine. 15th ed. United States of America: Mc Graw Hill; 2008.
21. Al-Zalabani A, Kasim K. Prevalence and predictors of adolescents
inverted question mark cigarette smoking in Madinah, Saudi
Arabia: A school-based cross-sectional study. BMC Public Health
2015;21:15-7.
22. Baheiraei A, Hamzehgardeshi Z, Mohammadi MR, Nedjat S,
Mohammadi E. Personal and family factors affecting life time
cigarette smoking among adolescents in Tehran (Rahman, #19):
A community based study. Oman Med J 2013;28:184-90.
23. Ebrahimi H, Sahebihagh MH, Ghofranipour F, Sadegh
Tabrizi J. Initiation and continuation of smoking in Iran:
A qualitative content analysis. Int J Community Based Nurs
Midwifery 2014;2:220-30.
24. Barreto RB, Pincelli MP, Steinwandter R, Silva AP, Manes J, Steidle LJ.
Smoking among patients hospitalized at a university hospital in
the South of Brazil: Prevalence, degree of nicotine dependence, and
motivational stage of change. J Bras Pneumol 2012;38:72-80.
25. Serhier Z, Bendahhou K, Soulimane A, Bennani Othmani M,
Ben Abdelaziz A. Prevalence of smoking in the Maghreb:A systematic review and meta-analysis. Tunis Med 2018;96:545-56.
26. Adeloye D, Auta A, Fawibe A, Gadanya M, Ezeigwe N,
Mpazanje RG, et al. Current prevalence pattern of tobacco smoking
in Nigeria: A systematic review and meta-analysis. BMC Public
Health 2019;19:1719.
27. Moosazadeh M. Meta-analysis of prevalence of smoking in
15-64-year-old population of west of Iran. Int J Prev Med
2013;4:1108-14.
28. Abdollahifard G, Vakili V, Danaei M, Askarian M, Romito L,
Palenik CJ. Are the predictors of hookah smoking differ from
those of cigarette smoking? Report of a population-based study
in Shiraz, Iran, 2010. Int J Prev Med 2013;4:459-66.
29. Boskabady MH, Mahmoudinia M, Eslamizade MJ, Boskabady M,
Shakeri MT, Heydari GR. The prevalence of smoking among
the population in the city of Mashhad (north east of Iran) and
pulmonary function tests among smokers. Pneumonol Alergol
Pol 2011;79:21-5.
30. Hamrah MS, Harun-Or-Rashid M, Hirosawa T, Sakamoto J,
Hashemi H, Emamian MH, et al. Smoking and associated factors
among the population aged 40-64 in Shahroud, Iran. Asian Pac J
Cancer Prev 2013;14:1919-23.
31. Boskabady MH, Farhang L, Mahmoodinia M, Boskabady M,
Heydari GR. Prevalence of water pipe smoking in the city
of Mashhad (North East of Iran) and its effect on respiratory
symptoms and pulmonary function tests. Lung India 2014;31:237-
43.
32. Ghelichkhani P, Yaseri M, Yousefifard M, Baikpour M,
Asady H, Oraii A, et al. The gap of cigarette and hookah smoking
between socioeconomic groups in Iran: Effect of inequalities on
socioeconomic position. Arch Iran Med 2018;21:418-24.
33. Goodwin RD, Grinberg A, Shapiro J, Keith D, McNeil MP, Taha F,
et al. Hookah use among college students: Prevalence, drug use,
and mental health. Drug Alcohol Depend 2014;141:16-20.
34. Grant A, Morrison R, Dockrell MJ. Prevalence of waterpipe
(Shisha, Narghille, Hookah) use among adults in great Britain and
factors associated with waterpipe use: Data from cross-sectional
online surveys in 2012 and 2013. Nicotine Tob Res 2014;16:931-8.
35. Mohammadpoorasl A, Abbasi Ghahramanloo A, Allahverdipour H,
Modaresi Esfeh J. Prevalence of Hookah smoking in relation to
religiosity and familial support in college students of Tabriz,
northwest of Iran. J Res Health Sci 2014;14:268-71.
36. Rahman S, Chang L, Hadgu S, Salinas-Miranda AA, Corvin J.
Prevalence, knowledge, and practices of hookah smoking among
university students, Florida, 2012. Prev Chronic Dis 2014;11:E214.
37. Combrink A, Irwin N, Laudin G, Naidoo K, Plagerson S,
Mathee A. High prevalence of hookah smoking among secondary
school students in a disadvantaged community in Johannesburg.
S Afr Med J 2010;100:297-9.
38. Hoseainrezaee H, Khodabandeh S, Kheradmand A,
Pilehvarzadeh M. Frequency of smoking and specialized
awareness among doctors and nurses of hospitals in Kerman,
Iran. Addict Health 2013;5:51-6.
39. Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, Auf R, et al.
The global epidemiology of waterpipe smoking. Tob Control
2015;24 Suppl 1:i3-12.
40. Heydari G, Yousefifard M, Hosseini M, Ramezankhani A,
Masjedi MR. Cigarette smoking, knowledge, attitude and
prediction of smoking between male students, teachers and
clergymen in Tehran, Iran, 2009. Int J Prev Med 2013;4:557-64.
41. Jamshidi Ardeshiri M, Moosazadeh M, Feizi Masouleh M,
Feizi Masouleh M, Kiani A, Fakhri M. Prevalence of smoking in
15-64 years old population of north of Iran: Meta-analysis of the
results of non-communicable diseases risk factors surveillance
system. Acta Med Iran 2013;51:494-500.
42. Moosazadeh M, Ziaaddini H, Mirzazadeh A, Ashrafi-Asgarabad A,
Haghdoost AA. Meta-analysis of smoking prevalence in Iran.
Addict Health 2013;5:140-53.
43. Bui TV, Blizzard L, Luong KN, Truong Nle V, Tran BQ, Ha ST, et al.
Declining prevalence of tobacco smoking in Vietnam. Nicotine
Tob Res 2015;17:831-8.
44. Kaleta D, Usidame B, Dziankowska-Zaborszczyk E,
Makowiec-Dąbrowska T, Leinsalu M. Prevalence and factors
associated with hardcore smoking in Poland: Findings from the
Global Adult Tobacco Survey (2009-2010). BMC Public Health
2014;14:583.
45. Sreeramareddy CT, Pradhan PM, Mir IA, Sin S. Smoking and
smokeless tobacco use in nine South and Southeast Asian
countries: Prevalence estimates and social determinants from
demographic and health surveys. Popul Health Metr 2014;12:22.
46. Thakur JS, Prinja S, Bhatnagar N, Rana S, Sinha DN. Socioeconomic
inequality in the prevalence of smoking and smokeless tobacco
use in India. Asian Pac J Cancer Prev 2013;14:6965-9.
47. Han J, Chen X. A meta-analysis of cigarette smoking prevalence
among adolescents in China: 1981-2010. Int J Environ Res Public
Health 2015;12:4617-30.
48. Ji CY, Chen TJ, Song Y, Hu PZ, Xing Y, Zhang L. Smoking status
of high school and college students in China. Chin J Sch Health
2009;30:109-11.
49. Niu L, Liu Y, Luo D, Xiao S. Current smoking behavior among
medical students in mainland China: A systematic review and
meta-analysis. Asia Pac J Public Health 2018;30:610-23.
50. Agrawal M, Jain S, Maitin N, Gupta T, Maitin S. Prevalence and
predictors of tobacco use among general public of Gorakhpur
district, India. J Oral Biol Craniofac Res 2015;5:16-20.
51. Coban FR, Kunst AE, Van Stralen MM, Richter M, Rathmann K,
Perelman J, et al. Nicotine dependence among adolescents in
the European Union: How many and who are affected? J Public
Health (Oxf) 2019;41:447-55.
52. Mohammad-Alizadeh-Charandabi S, Mirghafourvand M,
Tavananezhad N, Karkhaneh M. Prevalence of cigarette and water
pipe smoking and their predictors among Iranian adolescents. Int
J Adolesc Med Health 2015;27:291-8.
53. Etter JF. Associations between smoking prevalence, stages of
change, cigarette consumption, and quit attempts across the
United States. Prev Med 2004;38:369-73.
54. Linde BD, Ebbert JO, Pasker CK, Wayne Talcott G, Schroeder DR,
Hanson AC, et al. Prevalence and predictors of hookah use in US
Air Force military recruits. Addict Behav 2015;47:5-10.
55. Hopkins DP. The guide to community preventive services:
Tobacco use prevention and control: Reviews recommendations,
and expert commentary. Am J Prev Med 2001;20:1-88.
56. Owusu D, Quinn M, Wang K, Williams F, Mamudu HM.
Smokefree home rules and cigarette smoking intensity among
smokers in different stages of smoking cessation from 20 lowand-middle income countries. Prev Med 2020;132:106000.
57. Seangpraw K, Tonchoy P. Factors related intention to smoking
cessation among Thai people who joined quit smoking project for
the king: A cross-sectional study of Northern Thailand. J Ayub
Med Coll Abbottabad 2019;31:512-6.
58. Ahluwalia IB, Smith T, Arrazola RA, Palipudi KM, Garcia de
Quevedo I, Prasad VM, et al. Current tobacco smoking, quit
attempts, and knowledge about smoking risks among persons
aged ≥15 years - global adult tobacco survey, 28 countries,
2008-2016. MMWR Morb Mortal Wkly Rep 2018;67:1072-6.
)