Background: Tobacco use among adolescents is a major public health concern, and identifying predictors ofsmoking is necessary for planning prevention programs. The present study examined the relationship betweenrefusal self efficacy, self esteem, smoking refusal skills and water pipe (hookah) smoking among Iranian maleadolescents. Materials and
Methods: A cross-sectional study was conducted with 380 Iranian male adolescentsaged between 15-19 years selected by multistage sampling. The participants completed an anonymous, voluntary,self-report questionnaire. Variables independently associated with water pipe (WP) smoking were identifiedby multiple logistic regression analysis.
Results: The mean age of the participants was 16.7±1.3 years. Theprevalence of WP smoking was 17.3%. Logistic regression analysis revealed that knowledge (OR=0.56; 95%CI: (0.37-0.79), attitude (OR=0.69; 95% CI: (0.52-0.89), self esteem (OR=0.67; 95% CI: (0.55-0.82), smokingrefusal skills (OR=0.73; 95% CI: (0.55-0.87), and self efficacy (OR=.82; 95% CI: (0.61-0.93) were all signifcantprediting facotrs for adolescents WP smoking.
Conclusions: The findings have implications for public healthinterventions. Indeed, self efficacy and smoking refusal skills should be considered when developing tailoredmeasures for the prevention of WP smoking among adolescents.