Patterns of Waterpipe and Cigarette Smoking Among Young People in Central Iran: A Population‐Based Cross‐Sectional Study
Rahmatollah Moradzadeh, Javad Nazari, Irandokht Heidari, Faezeh Barati, Kiana Rezaei, Maryam ZamanianABSTRACT
Background and Aims
Tobacco smoking and waterpipe use are common among Iranian youth, with notable gender differences influenced by cultural factors. This study aimed to assess patterns of cigarette and waterpipe consumption among young people in central Iran.
Methods
This population‐based cross‐sectional study was conducted among 1384 young adults aged 18–30 years in urban and rural areas covered by Arak University of Medical Sciences. Participants were selected using multistage stratified cluster sampling. Data were collected via a structured self‐administered questionnaire assessing sociodemographic characteristics, tobacco use patterns (cigarette and waterpipe), exposure to secondhand smoke, and reasons for initiation and continuation of tobacco use. Independent t ‐tests and Chi‐square tests or Fisher's exact test were applied, with p < 0.05 considered statistically significant.
Results
Among 1384 participants (779 females and 605 males), current cigarette or waterpipe use was reported by 26.9% of males and 5.7% of females. In adjusted multinomial logistic regression, males had higher relative risk ratios for not‐daily (RRR = 2.02, 95% CI: 1.23–3.34) and daily use (RRR = 8.54, 95% CI: 2.70–27.03) compared with no use. Older age was associated with daily use (RRR = 1.13, 95% CI: 1.03–1.23). Cigarette initiation was more frequently reported among males than females, while waterpipe initiation showed a smaller gender difference. Males also reported greater secondhand smoke exposure and more recent cessation attempts.
Conclusion
Tobacco use was more prevalent and socially motivated among males. Gender‐sensitive interventions targeting cultural norms and misconceptions about waterpipe smoking are recommended.