Epidemiology and Determinants of Self-Injury Among High School Students in Iran: a Longitudinal Study.

Non-suicidal self-injury (NSSI) among adolescents is a major health concern globally. The epidemiology and determinant of NSSI have not been studied extensively in Iran. Thus, this longitudinal study sought to investigate the prevalence, incidence and contributing factors of NSSI among adolescents in Iran. This study was conducted at high school students aged 14-18 years old in the metropolitan city of Tabriz, located in north western Iran. Data were collected from 6229 10th-grade students at two time-points, with 12 months interval in October and November 2017 and 2018. A self-administered questionnaire was used to collect information on demographic, NSSI and cigarette and hookah smoking from the study participants. The results showed that lifetime prevalence of NSSI among students was 6.2% (95% confidence interval [CI]: 5.7 to 6.9) at the first assessment. Scratching and hair pulling were the most and least common methods of self-injury, respectively. Over the one year, 206 students (3.6% CI 95%: 3.1-4.1) reported the onset of NSSI. Tobacco smoking and previous year average grade were related to the incidence of NSSI. Although gender was significantly associated with the prevalence of NSSI, the relationship between gender and incidence of NSSI was not significant. Although the prevalence of NSSI was low among adolescents, the incidence rate was considerable. Further studies are required to understand the risk factors of NSSI in Iran.

Associations between optimism, tobacco smoking and substance abuse among Iranian high school students.

Background: Optimism is known to be associated with many health behaviors. However, the associations between optimism, tobacco smoking and substance abuse in adolescents are not well documented. This study aimed to address this research gap in a large school-based population. Methods: Participants (N = 1104) were selected based on multi-stage cluster sampling method. Cigarette and hookah smoking behaviors, illicit drug use, optimism, and relevant covariates were measured using a validated questionnaire. Data were analyzed using ordinal logistic regression. Results: After adjustment, higher optimism score was a protective factor against being situated in advanced stages of cigarette smoking (odds ratio [OR] = 0.88, 95% CI: 0.84-0.91), hookah smoking (OR = 0.91, 95% CI: 0.88-0.94), and illicit drugs usage (OR = 0.90, 95% CI: 0.85-0.95). Moreover, the results showed that negative-stability and negative-globality domains of optimism were significantly higher among advanced-stage smokers and illicit drug users. Conclusion: Optimism was found to be a protective factor against tobacco smoking and substance abuse; whereas pessimism (negative-stability and negative-globality) was found to be a determinant factor. Further research is needed to investigate the effects of optimism on the transition in cigarette and hookah smoking stages.

Obscenity of Cigarette and Hookah Smoking in Iranian Adolescents: A Longitudinal School-based Study.

BACKGROUND: There is a very limited information on the obscenity of cigarette and hookah smoking among adolescents. Using a large and representative longitudinal sample of adolescents (n = 4820) aged 14-19 years from Tabriz (a metropolitan city in northwestern Iran), this study aimed at comparing the obscenity of cigarette and hookah smoking and assessing factors associated with obscenity of smoking. Moreover, we examined how the obscenity of cigarette and hookah smoking affected by the progress in the stages of cigarette and hookah smoking. METHODS: In this longitudinal study, a random sample of high-school students was selected in Tabriz in 2010. Using a valid and reliable self-administered questionnaire, the data from the sampled students were collected twice at two points in time, 12 months apart. Multivariate backward logistic regression was used to determine the effect of the transition in cigarette (or hookah) smoking stages on the obscenity of cigarette (or hookah) smoking. RESULTS: While 3,079 (63.9%) students expressed that obscenity of cigarette smoking is higher than obscenity of hookah smoking, 1,741 (36.1%) students expressed that obscenity of hookah smoking is higher than obscenity of cigarette smoking. The results of multivariate backward logistic regression indicated that the transition in cigarette (hookah) smoking stages was not related to the obscenity of cigarette (hookah) smoking. CONCLUSIONS: The results showed that obscenity of hookah smoking was less than obscenity of cigarette smoking, especially among females. Further study is required to understand the effect of obscenity on smoking and transition to different stages of cigarette and hookah smoking.

Changes in Risk-Taking Behaviors during the First Year of College in the Northwestern Iran: A Latent Transition Analysis.

BACKGROUND: First year of university is a critical life transition period with an increased probability of taking risky behaviors. We aimed to examine the transitions in risky behaviors in the first year of college in the northwestern Iran using latent transition analysis (LTA). STUDY DESIGN: A longitudinal study. METHODS: A random sample of 1406 freshmen enrolled in three universities in Tabriz City (the capital city of East Azerbaijan Province, northwestern Iran) were evaluated twice in November 2014 and 2015. A multiple-choice self-administered questionnaire was used to collect data on risky behaviors and demographic characteristics of students. LTA was performed to examine the prevalence and changes in risky behaviors (cigarette and hookah smoking, illicit drug use, alcohol consumption and risky sexual behaviors) among the students. RESULTS: The LTA model revealed four interpretable statuses. The prevalence data showed that 77.1%, 12.3%, 8.3% and 2.3% of students were "risk-free", "tobacco user", "sexual risk-taker" and "multiple risk-tacker", respectively in the first assessment. Over the period of one year, 4.2% and 6.1% of risk-free students became tobacco user and sexual risk-takers, respectively, and 22.4% of tobacco user students, transfer to the multiple risk-taker group. CONCLUSION: The prevalence of risk-taking behaviors increased during the freshman year. Tobacco smoking was  predispose acquiring more risky behaviors. Probability of transition to the multiple risk-taker group was higher among tobacco users.