مقالات رزومه دکتر نوذر نخعی

Drug use during pregnancy is a growing public health problem worldwide. This study determined the prevalence of illicit drug use among pregnant women in Kerman, Sought East Iran. This cross-sectional study was performed in 2020 on the 966 pregnant women referring to the Central Clinical Laboratory of Kerman for routine pregnancy tests. Urine sample of pregnant women was tested anonymously in two stages. At first, a qualitative screening test was done using the rapid immunoassay method. Then for positive specimens, thin layer chromatography was used to confirm the initial positive results. Data were analyzed using Chi-square test and multivariable logistic regression. The mean age of the participants was 27.3±6.6 years.  Most of the respondents (93.8%) were urban dwellers. Also, 7.0% (95% CI: 5.4–8.7) of urine samples were positive for illicit drug. Opium was the most frequently used drug (83.8%). No urine sample was positive for marijuana and tramadol. The older the participants, the more likely they used drugs (odds ratio=1.05; CI 95%:1.01-1.09). Women with low socioeconomic status were nearly 2.2 times more likely to use illicit drugs. The prevalence of drug use is alarming among pregnant women in South eEast Iran. Considering this issue is necessary during prenatal care.

Understanding the relationship between religiosity and health behaviors helps us to tailor messages based on cultural beliefs. We conducted an online survey to find any relationship between fatalistic beliefs, religiosity, and mask-wearing in an Islamic context. The participants consisted of 503 subjects from the adult population of Kerman Province located in the Southeast of Iran. The measurement tool consisted of four sections; (A) demographic characteristics, (B) three items related to mask-wearing, (C) The God Locus of Health Control (G LHC) scale consisting of six items measuring fatalistic beliefs, (D) The Duke University Religion Index (DUREL) consisting of five items measuring religiosity. The mean age of the participants was 36.5 ± 10.9 years, and females consisted 60% (n=302) of the sample. More than one-fifth (n=109) reported a history of COVID-19 infection. Approximately one-third of respondents (n=163) reported full mask adherence. Logistic regression model showed that there was no significant relationship between mask adherence and religiosity (odds ratio: 1.03; 95% confidence interval (CI): 0.99-1.08) and fatalistic beliefs (OR:1.01; 95% CI: 0.98-1.04 ).We found no association of fatalism and religiosity with the mask-wearing during COVID-19 in the Iranian Muslim population. So we can conclude that religious beliefs may have no place in cultural tailoring of health messages for promoting mask adherence.

Substance abuse in women has an increasing trend in all socio-economic classes. In addition to the fetal consequences, this problem has many other economic and social consequences as well.This study aimed to determine the prevalence of substance abuse and its related factors in pregnant women.

This descriptive cross-sectional study was performed employing a self-administered valid questionnaire on 587 pregnant women in Kerman, Iran who referred to public health centers and private offices to receive prenatal care. Participants were recruited from January to February 2020 using a multistage sampling method.

The most prevalent substances used during pregnancy (current use) were waterpipe (8.5%), opium (2.6%), and alcohol (1.7%).Substance abuse in first-degree relatives was a very strong correlate of substance abuse in pregnant women (OR = 7.26). The low level of education of pregnant women's husbands was also a strong predictor of substance abuse in pregnant women. (OR = 3.15).

Since substance abuse by family members was the strongest correlate of drug abuse during pregnancy, family-based interventions should be tailored to address early detection of such vulnerable women and necessary counseling services.

Distal polyneuropathy is a common complication of diabetes mellitus with a considerable negative impact on the quality of life. The aim of this study was to evaluate the effect of dry cupping on distal polyneuropathy in diabetic patients. This controlled clinical trial was performed on 34 patients with diabetic polyneuropathy (DPN) for eight weeks. The non-invasive dry and fixed cupping therapy was performed on the sole of the right foot in the patients three times a week for 10 min, and the left foot of the same patient was considered as a control. The severity of diabetic neuropathy was measured using the modified Toronto Clinical Neuropathy Score (mTCNS), and the symptom and sensory test scores were determined. 20 patients (40 feet) completed the study. There was a significant difference between the control foot and the treated foot in terms of the mTCNS after four and eight weeks (p-values = 0.004 and 0.001, respectively), in terms of the sensory test scores after four and eight weeks (p-values = 0.007 and 0.005, respectively), and in terms of the symptom scores after eight weeks (p-value = 0.002). For the first time, this study demonstrated that cupping therapy might be effective as a complementary treatment in alleviating the symptoms of DPN, although understanding the underlying mechanism requires further investigation.

Parents' oral health literacy may be a reliable predictor of children's oral health. Therefore, the present study was conducted to develop and validate a questionnaire to assess parents' oral health literacy about their children's oral health. This study was conducted from April 2020 until October 2020. Questionnaire items were developed by evaluating  content validity based on expert opinions, content validity ratio, and content validity index, and cognitive interview. Random sampling was used to recruit a total of 500 patients from referral hospitals in the city of Kerman. Based on factor analysis, construct validity included exploratory factor analysis via SPSS software version 22, and confirmatory factor analysis via Mplus software version 7.4. The invariance of the model evaluation and the evaluation of the reliability of the questionnaire were assessed based on Cronbach's alpha coefficient. First, 71 items were chosen for evaluation, and then 19 items were promoted to the next stage, based on the content validity coefficients. The results of the exploratory factor analysis led to the extraction of a three-factor model of Parent's Oral Health Literacy Measure (POHeLM) about children's oral health. These three factors explained 56% of the total variance of the questionnaire altogether. These three factors include the accessibility domain (two items), the utilization domain (eleven items), and the communication domain (six items). Model fit indices based on confirmatory factor analysis confirmed the proper fit of the three-factor model. Also, in measuring the factor invariance, the model's validity in both male and female was authenticated. The Cronbach’s alpha coefficient was calculated as 0.81.  This study shows that the POHeLM questionnaire possesses appropriate validity and reliability by 19 questions and 3 subclass.

Pulp stones are calcified masses with unknown etiology in the dental pulp complicating access to the pulp and root canals during root canal therapy. Aim of this study is to determine the prevalence of pulp stones in patients referring to Kerman University School of Dentistry. This cross-sectional study was undertaken on 4413 teeth in 852 patients and 1052 bitewing and periapical radiographs. The patients were 3–60 years old and had been referred to the Kerman School of Dentistry for various reasons. Data were collected by radiographic evaluations and the use of a checklist and were then analyzed using SPSS version 19 and the chi-square test with the significance level set at 0.05. The prevalence of pulp stones was estimated at 13.4% in the patients, significantly increasing with age (P = 0.001). Most pulp stones were 12.2% in the maxilla and 10.4% in the mandible, indicating a significant difference between the two jaws (P = 0.001). The highest prevalence of pulp stones was related to the permanent first molars. Most pulp stones were significantly higher in female subjects than in males (P = 0.004), with no major difference between the left and right sides (P = 0.07). No significant relationship was found between the prevalence of pulp stones with tooth restoration and dental caries (P = 0.130). The prevalence of pulp stones increased significantly with age. In this study, the youngest participant was a 4-year-old male, and the oldest was a 60-year-old female.

This study aimed to determine the success rate of the combination of buccal infiltration (BI) and inferior alveolar nerve block (IANB) injections in irreversible pulpitis in mandibular molars after premedication with ibuprofen.

From 132 patients participated in the study, 120 patients were included. One hour before root canal treatment, patients with mandibular molars with symptomatic irreversible pulpitis received either a 600 mg ibuprofen capsule or a placebo. All patients received 2% lidocaine with 1:80000 epinephrine and 4% articaine with 1:100000 epinephrine for IANB and BI, respectively. Patients’ pain was evaluated using the Heft-Parker visual analog scale during the preparation of access cavity, exposure of pulp, and instrumentation of root canal. The success of anesthesia was defined as the absence of pain or mild pain. The Chi-square and t-test were employed for data analysis.

The difference between patient age and gender in the two groups was not significant (P>0.05). The anesthesia success rate was 85% in the premedicated and 70% in the placebo group, with statistically significant results (P=0.049).

Based on this triple-blinded randomized clincal study, mandibular molars with irreversible pulpitis were not thoroughly anesthetized by a combination of IANB+BI after premedication with ibuprofen (600 mg), even though anesthesia success was improved significantly by ibuprofen premedication.

Heat wave adaptation is a new concept related to experiencing heat. The present study aims at investigating a conceptual definition, that is, the mental framework of heat wave adaptation and its strategies.

A phenomenological study was performed to explain the mental concept. At the same time with the data collection process, data analysis was also performed using Colaizzi method. Semi‑structured interview method and purposeful sampling with maximum variety were used. Interviews were conducted with 23 different subjects in the community. The accuracy of the data was guaranteed using Lincoln & Guba scientific accuracy criteria.

The two main themes of the adaptation paradigm as well as its strategies were divided into the main categories of theoretical and operational concepts, as well as personal care measures and government measures. Under the category of individual measures, we obtained “clothing, nutrition, building, place of residence and lifestyle,” and under the category of governance actions, the “managerial, research, health, organizational” subcategories were obtained.

According to the results of the conceptual‑operational definition, heat wave adaptation is an active process and an effort to reduce the adverse effects of heat waves on individual and social life, and striking a balance that will not only result in individual awareness and actions that will lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in the community. On the one hand, heat waves could not only be regarded as a threat or danger, but can also become an opportunity for the development of a community through identification and smart measures, and for adaptation, the community must take it as a risk. The community should have a plan in advance, apply the necessary rules and training, and use the new facilities and rules where necessary. This practical concept definition includes the main features of heat wave adaptation.

The first 1000 days of life last from the beginning of pregnancy to the age of two, a unique step that shapes the basis for a person’s health over their lifetime. Numerous studies have indicated the relationship between one’s first 1000 days of life and the consequent adverse outcomes in adulthood. However, to the extent that we have reviewed it, not a single study has shown the relationship between various aspects of an individual’s first 1000 days of life and the probability of drug consumption in adult life. Hence, the primary purpose of this narrative review was to understand the role of the first 1000 days of life on vulnerability to drug abuse later in life.

This article is a narrative review that has identified the role of the first 1000 days of life on susceptibility to substance abuse later in life. The articles were extracted from valid databases, including PubMed, Scopus, Science Direct, Web of Science, and Embase.

Various significant research has pointed to the mother’s distress and anxiety during pregnancy through embryonic planning, influencing the planning of the hypothalamic-pituitary-adrenal (HPA) axis and epigenetic changes. The intestinal microbiota is a part of a complex link named the microbiota-gut-brain axis that can affect drug abuse through the variety and number of intestinal microbiota. On the other hand, a mother’s drug consumption during pregnancy can function as chronic stress by affecting the enteric nervous system (ENS), which activates the concurrent axis of HPA and dopamine pathways by changing the reward circuit and the subsequent increase in drug abuse. The results indicated that various factors, such as exposure to adverse childhood experiences (ACEs), parental separation, and attachment insecurity, increase the probability of drug abuse in adulthood. Nevertheless, the quality of nurturing care during the first 1000 days of life and the mother’s warm relationship with children may hinder the increase in addiction in society.

The first 1000 days of one’s life are a crucial and delicate stage. If these days are tainted with unpleasant events, the various mechanisms can reduce a person’s resilience to drug abuse in later life. How the first 1000 days of an infant’s life and the quality of this period, such as prenatal stress, substance use during pregnancy, ACEs, maternal-infant bonding, maternal separation (MS), and intestinal microbiota, can affect drug abuse in the future. As a result, focusing on the first 1000 days of life is critical to adapting prevention strategies. Health policymakers can design suitable entries during pregnancy and early childhood to reduce the probability of drug abuse.

Traumatic events and psychological damage are common. Identifying different types of traumatic events contributes to the development of psychopathology and can be very helpful in macroeducational and treatment planners. The current study extracted the patterns (overlap) of different traumatic events that Iranian college students commonly experience, with the aim of understanding their association with posttraumatic growth (PTG) and religiosity.

Four hundred and sixty‑six students from Kerman universities completed a cross‑sectional survey about religion, and questions about PTG and traumatic events have experienced in the past 5 years. The latent class analysis (LCA) was used for extracting patterns of traumatic events, and the one‑way ANOVA test was used to compare PTG and religiosity across these classes in Iranian college students.

The LCA revealed that a three‑class solution had an adequate relative and absolute fit. The three classes were labeled and characterized as multiple‑traumatic events (2.9%), intermediate‑traumatic events (31.1%), and low‑traumatic events (66.0%). In ANOVA results for PTG and Duke University Religion Index (DUREL) domains across classes, individuals in the multiple‑traumatic classes had the lowest score of PTG and DUREL domains.

Although the current study showed the relative frequency of multiple‑traumatic events in Iranian students is low, individuals categorized in this class had the lowest PTG, and these findings reveal the necessitation of planning and interventions for PTG.

Social media addiction (SMA) led to the formation of health‑threatening behaviors that can have a negative impact on the quality of life and well‑being. Many factors can develop an exaggerated tendency to use social media (SM), which can be prevented in most cases. This study aimed to explore the reasons for SMA.

This qualitative study was conducted using content analysis. A total of 18 SM addicted subjects were included through purposive sampling. Data were collected through semi‑structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method.

The main category of “weakness in acquiring life skills” was extracted with three themes: “problems in socializing” (including communicating and escaping loneliness), “problems in resiliency” (including devastation in harsh conditions and inability to recover oneself and “lack of problem‑solving skills”(including weaknesses in analysis and decision making and disorganization in planning).

Weakness in life skills plays an important role in individuals’ addiction to SM and formation of the health‑threatening behaviors. Since SMA can affect behavioral health, policymakers must adopt educational and preventive programs to increase the knowledge and skills of individuals in different societies in the modern world.

Promoting self-care practice, as a critical strategy for enhancing the quality of life in patients with Multiple Sclerosis (MS) is a challenging issue. This study aimed to propose a model of health-promoting self-care behaviors in MS patients.

In this cross-sectional study, 200 patients with MS, who had referred to the Hospital for Special Diseases in Kerman City, Iran, were chosen. The main data collection instruments were the multiple sclerosis knowledge questionnaire, the Rosenberg self-esteem scale, multiple sclerosis self-efficacy scale, questionnaire of perceived barriers and benefits of self-care behaviors, social support, the health promotion lifestyle profile II, and resilience and sense of coherence scale. Data analysis was conducted in SPSS V. 22 and AMOS18 software. The Structural Equation Modeling (SEM) was also used for further analysis of data

The model explained 82% of variance in Health-Promoting self-care Behavior (HPB). The results of the final model obtained from the SEM showed that self-efficacy (β=0.53, SE=0.04, P= 0.007), self-esteem (β=0.39, SE=0.04, P=0.005), social support (β=0.36, SE=0.04, P=0.009), sense of coherence (β=0.34, SE=0.07, P=0.006), resilience (β=0.33, SE=0.07, P=0.018), and perceived benefits (β=0.25, SE=0.05, P=0.009) had a positive and significant relationship with HPB.

The self-care empowerment model in patients with MS presented in this study can be used as a framework for designing health promotion interventions to improve the quality of life of patients with MS.

Measuring child abuse and adverse experiences is a critical task with regard to its long‑term impact on the health of individuals and communities. The purpose of this study was to validate the Persian version of the International Adverse Childhood Experiences Abuse Short Form (ACE‑ASF) in Iranian society.

This cross‑sectional study was conducted in Kerman, southeast of Iran, in 2019, on 494 students from Kerman University of Medical Sciences, selected by convenience sampling method. Psychometric properties of the questionnaire were examined after the forward and backward translation processes. The factor structure of the questionnaire was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The concurrent validity of the questionnaire was assessed using the childhood trauma questionnaire (CTQ). Cronbach’s alpha and corrected item‑total correlation were used to measure reliability.

The mean age of participants was 24.3 ± 5.3 years. Based on EFA, two physical–emotional abuse and sexual abuse factors were obtained. The CFA fit indices well supported two extracted factors. The CFA showed acceptable factor loadings. The internal consistency coefficient of Cronbach’s alpha was 0.75 for the physical–emotional abuse factor and 0.77 for the sexual abuse factor. The correlation coefficient of ACE‑ASF and CTQ was r = 0.56. The reliability index of intraclass correlation coefficient was 0.73 (95% confidence interval: 0.60–0.84).

The Persian version of the ACE‑ASF questionnaire has acceptable psychometric properties.

The use of waterpipe tobacco smoking (WTS) is on the rise throughout the world, especially among young people and even athletes. There is a belief among consumers that exercise prevents the harmful effects of hookah smoke on the body. We examined this belief by evaluation of lung injury following to concurrent WTS and swimming endurance training in male Wistar rats.

Animals were randomly divided to sedentary control (CTL) group, exercise training group (Ex group), sedentary WTS (S) group, and exercise plus WTS (S + Ex) group.

8 weeks of WTS was associated with significant increase in serum level of cotinine, lung damage, reduction in alveolar number AN/SA (mm2) and increase in malondialdehyde (MDA) level of lung tissue. Combination of exercise with WTS significantly decreased these negative effects; however, it could not fully protect the lung from smoking damage. Waterpipe smoking (WPS) also significantly increased the pro-inflammatory cytokines of lung tissue such as tumor necrosis factor alpha (TNF-α) (P < 0.001), interleukin 1 beta (IL-1β) (P < 0.010), and IL-6 (P < 0.050) in comparison with CTL group. Exercise training to some degree reduced the levels of pro-inflammatory cytokines and increased the level of IL-10 as an anti-inflammatory IL and glutathione peroxidase (GPX) activity in animals exposed to WTS.

It is suggested that combination of mild to moderate exercise with WTS may attenuate the hookah smoking-induced lung damage. This effect partly is mediated through balancing of pro/anti-inflammatory and redox systems.

Evidence is accumulating that the pattern and nature of marital relationships are very different in different cultures. This nationwide study aimed to determine marital satisfaction and the prevalence of emotional divorce as well as to identify the sociodemographic correlates in a Muslim population.

In this cross‑sectional study, one‑third of Iran’s provinces were selected randomly and a representative sample of inhabitants of their central city was included in the study. The ENRICH marital satisfaction scale was used to determine marital satisfaction levels. A single‑item measure with confirmed validity and reliability was used to find out about emotional divorce. The demographic variables included respondent’s age, spouse’s age, gender, educational level, residency, childbearing, and premarriage familiarity.

Of the 2033 participants, 1034 were women (50.9%). Nearly one‑third of both men and women had academic degrees. Almost 53% of them were satisfied with their marital life and 9.7% had emotional divorce. Men with academic degrees had a higher probability of marital satisfaction (odds ratio [OR] =1.26, 95% confidence interval [CI]: 1.04–1.53) and a lower prevalence of emotional divorce (OR = 0.37, 95% CI: 0.24–0.58).

This study showed a relatively high percentage of marital dissatisfaction as well as emotional divorce. Policymakers should strengthen premarriage education programs and postmarriage counseling centers.

Antibiotics prescribed for infections have diverse effects on microbiota and the pathogen Clostridium difficile (C. difficile) as the most important antibiotic-associated diarrhea. This study aims to determine the gene expression of toxins A and B at the transcription level in the sub-MIC of vancomycin (VAN), clindamycin (CLI), and ceftazidime (CAZ) alone and in combination.

The MIC and fractional inhibitory concentration (FIC) of two C. difficile samples (a clinical isolate and ATCC 9689) were determined by microdilution and checkerboard microdilution methods, respectively. The total RNA was extracted from the medium inoculated with ~106 CFU/mL of fresh bacteria in the pre-reduced medium containing ½ MIC of antibiotics alone and ½ FIC of antibiotics in combination. Real-time PCR was performed by sybrGreen methods in triplicate, and the data were analyzed by the comparative ∆∆CT method.

All antibiotics except CAZ (alone and in combination) decreased the gene expression of toxins A and B within 24 hours. VAN and CLI reduced toxin gene expression within 24 and 48 hours. However, CAZ alone and in combination with VAN as well as CLI increased the gene expression of toxins A and B.

The results confirmed toxin gene transcription and toxin production are associated with the type of isolates and antibiotics, as well as the combined form of antibiotics. This could be the reason which can explain the occurrence of C. difficile infection among patients who were treated with the third generation of cephalosporins alone and in combination with another antibiotic in the form of combinational therapy.

The growing supply and prevalence of waterpipe (WP) smoking among Iranian adolescents have become a concern for both families and policymakers. The aim of this study was to determine the factors underlying WP use and also to design an intervention program based on social cognitive theory (SCT) aimed to reduce the demand for WP smoking among male adolescents.

This quasi‑experimental study involved 189 high‑school students in Kerman, Iran, who were split into two groups, an intervention group and a control group. A validated questionnaire
based on SCT constructs was used to collect data. The intervention was performed over four sessions with a focus on preventing WP smoking.

Before intervention, the lifetime and current‑use prevalence of WP smoking across both groups was 48.5% and 20.2%, respectively. In the intervention group, the most change was related to knowledge score from 10.70 ± 4.38 to 16.52 ± 3.89 (P < 0.0001) and outcome values score from 12.40 ± 3.81 to 13.53 ± 4.23 (P = 0.007); however, in the control group, no significant changes were seen in posttest scores. The scores for self‑efficacy (P = 0.21), outcome expectations (P = 0.09), and environment constructs (P = 0.06) did not show any statistically significant changes after the intervention in both groups. Overall, there was no significant difference in the rate of WP smoking after the intervention.

Based on the results of this study, although some construct scores showed significant differences after the intervention, there was no significant change in the prevalence of WP smoking. More effective educational interventions based on this theory but with a greater focus on self‑efficacy and environmental influences may be warranted.

Multiple sclerosis (MS) is a progressive central nervous system disease that has an enormous effect on a patient’s quality of life due to physical complications and psychological problems.

The purpose of this study is to investigate the effect of self-care education program based on Health-Promoting Self-Care Behaviors System Model on quality of life, resilience, and sense of coherence in patients with MS.

In this randomized controlled clinical trial, 80 patients with MS referred to hospitals for special diseases in Kerman were enrolled using systematic sampling method and then randomly assigned to the intervention and control groups. The main research instruments, including demographic information checklist, Multiple Sclerosis Quality of Life (MSQOL-54), Connor-Davidson scale, Resilience Scale and Sense of Coherence Scale were completed by subjects in both intervention and control groups. The intervention group participated in 18 training sessions that addressed the needs of patients. The two groups completed the questionnaires one week and two months after intervention again. Generalized Estimating Equations (GEE) (GEE) test was used for data analysis.

Pre-intervention results revealed that intervention and control groups were not significantly different in the mean scores of most dimensions of quality of life and sense of coherence (P > 0.05). However, intervention and control groups were significantly different in mean scores of all dimensions of quality of life, resilience and sense of coherence one week and (P < 0.05) and two months (P < 0.05) after the intervention. The results of GEE test also reflected a meaningful difference in the intervention group in terms of increased mean scores in all dimensions of quality of life (P < 0.05), resilience (69.60 ± 6.62) (P < 0.05) and sense of coherence (74.50 ± 3.52) (P < 0.05) one week and two months after the intervention compared to the baseline. However, this improvement was not observed in the controls (P > 0.05).

Teaching health-promoting self-care behaviors system model improves the quality of life, resilience, and sense of coherence in patients with MS. Therefore, it is recommended to plan and implement self-care training interventions in accordance with this model for all patients with MS.

Substance abuse among students is a worldwide concern. As a widely applied method, nominative technique is employed to estimate the prevalence of a specific behavior among a population by questioning informed people.

The current study aimed at examining the necessity of including a dummy drug (i.e., relevin) in the list of drugs that are requested via nominative technique.
Patients and

Totally, 12 schools were selected using a stratified cluster sampling method in Kerman city, Southeastern Iran, and all their grade 10 students were recruited in the current study. A well-validated questionnaire was also used to ask students about the frequency of using six substances among their classmates, in addition to the items associated with risk-taking tendency and self-report substance use by themselves. To analyze the data chi-square, Cramer’s V, multiple logistic regression tests was used.

The mean age of the students recruited in the current study was 16.2 ± 0.6 years (n = 830) and approximately 53% of them were female. The consumption of relevin by classmates was reported higher in females (10.2%) than males (6.1%), in urban areas (10.6%) than rural ones (4.0%), and in subjects with a higher tendency toward substance abuse (17.6%) (P < 0.05). The belief in the use of relevin by classmates was not correlated with perceived use of any drugs by classmates. Frequency of self-reported substance use in subjects choosing the use of relevin by classmates was also comparable to those who did not declare the use of relevin by classmates.

It was concluded that there might be no need for the inclusion of a dummy drug as an indicator of reliability to the list of substances that are being asked of students in the nominative technique

Explaining the risk factors of waterpipe smoking (WS) is very necessary in prevention programs. The aim of this study was determining the risk factors and the prevalence of WS in adolescents based on the social cognitive theory (SCT).

This cross-sectional study was conducted among urban adolescents in two provinces located in the South East of Iran. We recruited 1,218 adolescents (girls=595 and boys=623) through multistage sampling during the period October 2017 to February 2018. The data collection tool was a self-administered standardized questionnaire that included basic baseline characteristics, SCT constructs items and questions about WS behavior in the participants. The data were analysed using SPSS software version 22.0.

The ever use prevalence of WS in boys was 43.8% (n= 264), and in girls 27% (n=160). WS in family member (OR=1.87, CI: 1.32-2.63; p<0.001) and intimate friends (OR=2.34, CI: 1.70- 2.26; p<0.001) were the most important risk factors for adolescents. In the relation of WS with constructs of SCT: outcome expectations (OR=0.64, 95% CI: 0.50-0.84; p<0.001), outcome expectancy, (OR=0.65, 95% CI: 0.55-0.85; p=0.002) self-efficacy, (OR=0.30, 95% CI: 0.23- 0.41; p<0.001), and situational perception (OR=0.63, 95% CI: 0.47- 0.84: p=0.002) were the most important and related factors of WS. Boys were 1.92 times (OR: 1.06 – 2.43; p<0.001) more exposed to water-pipe smoking than girls.

The prevalence of WS was notable in students especially in boys. Peer group and family are important risk factors for tendency toward WS in adolescence. Also, lower score in SCT constructs such as knowledge, self-efficacy and situational perception in adolescents are important risk factors for WS in participants.

In the early decades of the 20th century, discussions regarding alcohol were dominantly directed toward itstherapeutic uses, but authorities now state that any level of alcohol consumption poses negative effects onhealth. Over recent months, increased attention has been devoted to disease burdens attributable to alcoholuse worldwide. As more and more studies are conducted to illuminate the harmful effects of alcohol ondifferent body systems, the mounting evidence generated requires documentation and publication. Thecurrent review was aimed at providing an overview of the recent literature on the adverse consequences ofalcohol consumption.