asghar mohammadpoorasl

Smoking at a younger age puts people at greater risk for health damage. This study aimed to investigate the relationship between the age of smoking onset and high-risk behaviors such as smoking, alcohol consumption, substance abuse, and high-risk sexual behavior among university students in Tabriz, Iran.

This web-based, cross-sectional study was conducted in Tabriz, Iran, in 2019. A total of 3,649 students were included in the study according to the proportion of students in each university. The required information was collected through an online questionnaire. Logistic regression analysis was used to assess the relationship between the age of smoking onset and high-risk behaviors.

The mean (standard deviation) age of the participants in the study was 22.85 (3.66) years old, and 55.7% were boys. The findings of the study indicate that students who initiated smoking at the age of 16 or younger exhibited higher likelihoods of alcohol consumption over the previous 30 days (OR= 1.77, CI 95%: 1.20 - 2.62) and participation in unsafe sexual practices (OR= 1.54, CI 95%: 1.06 - 2.26) compared to their non-smoking counterparts.

  Early smoking onset is associated with high-risk behaviors. The age of onset of smoking should be considered as one of the factors associated with high-risk behaviors, and smoking prevention programs should be started from adolescence.

Usually non-daily smokers do not consider themselves smokers, and they are at a higher level of health risks due to smoking compared to non-smokers. This study aimed to identify the prevalence of non-daily smoking (NDS) and its associated factors among university students.

This cross-sectional web-based study was performed in Tabriz, Iran. A proportional random sample of 3666 students from all universities of Tabriz were recruited from July to August, 2019, and an online questionnaire was used to collect data. Predictors of NDS were investigated using a multiple logistic regression model.

A total of 15.7% and 7.8% of the students were daily and NDSs, respectively. Compared to the non-smokers, the NDSs were more likely to exhibit high-risk behaviors such as substance abuse (odd ratio [OR]=2.96; 95% CI: 2.12-4.13), alcohol drinking (OR=2.54; 95% CI: 1.78-3.62), hookah smoking experience (OR=9.30; 95% CI: 6.06-14.25), and regular hookah use (OR=24.22; 95% CI: 14.86-39.46). Compared to daily smokers, NDSs were more likely to be female gender (OR=0.16; 95% CI: 0.10-0.24), denial of being a smoker (OR=11.69; 95% CI: 6.86-19.91), not addicted to nicotine (OR=10.02; 95% CI: 4.21-23.85), and less likely to have an intention for quitting in recent months (OR=2.27; 95% CI: 1.28-4.04).

Non-daily smokers do not consider themselves smokers and have no intention to quit smoking. They are more prone to present high-risk health behaviors. Health policymakers should pay more attention to NDSs while planning smoking cessation programs.

Substance abuse has significant health impacts on families and society as a whole. We aimed to provide detailed prevalence estimates of substance abuse among the Azar Cohort Study respondents in Tabriz, Iran.

Data on 15 006 participants of Azar Cohort Study were analyzed. The variables included tobacco smoking, alcohol use, drug abuse, and socio-demographic characteristics. The prevalence of substance abuse (with a 95% confidence interval) was calculated using the direct standardization method.

Overall, 9.3% and 6.2% of the participants were regular and heavy cigarette smokers, respectively. Also, 1.9% and 2.1% of participants reported a history of using illicit drugs and alcohol, respectively. Substance abuse was more prevalent among males than females. Substance abuse varied significantly with age and socioeconomic variables.

We identified specific demographic and socioeconomic groups with a higher prevalence of all studied behaviors. Such high-risk groups should be targeted when designing substance abuse prevention programs.

Smoking is a public health problem that affects the adolescent population’s health. This study aimed to investigate the relationship between extroversion (compared with introversion) and transition in cigarette and hookah smoking stages in high‑school students to use the results in smoking prevention programs.

A sample of 2312 students aged 15–16 years in Tabriz were included in the study. Demographic characteristics, cigarette, hookah smoking status, and Eysenck’s extroversion questionnaires were completed by all students in the selected schools. Eight months later, cigarette and hookah smoking status were assessed again to determine transition in smoking stages. The marginal homogeneity (MH) test was used to compare the smoking status at the beginning and 8 months later. The generalized estimating equation (GEE) method with the ordinal link was applied to estimate the effect of extroversion on transition in smoking stages.

The mean (standard deviation) age of the students participating in the study was 15.5 (0.5) years. MH test results showed that, in general, transmission in the stages of both cigarette and hookah smoking in 8 months was significant in students (P‑value < 0.0001). Extrovert personality had a significant positive effect on the transition from lower stages to higher cigarette and hookah smoking stages according to the GEE with ordinal link (P = 0.01). In cigarette and hookah smoking, extrovert persons transited to higher stages 1.64 and 1.55 times more than introvert persons.

Being an extrovert person had a significant effect on the transitioning to higher stages of smoking cigarettes and hookah. In designing cognitive programs to prevent people from smoking or encourage them to quit smoking, considering this dimension of personality trait can be useful in the efficacy of the program.

The promotion of the health of the members of a society is based on the assessment of the situation of that society. This study was conducted in the Soufian district of Shabestar city with the aim of identifying and prioritizing its problems and needs with the direct participation of the people.

This was a cross-sectional study conducted in the Sufian District of Shabestar city in 2019, the methodology used being based the 8-phases model of North Carolina. The community health assessment was performed in 8 phases. The first seven phases included identifying and prioritizing the problems of the District, and the eighth was developing operational plans to solve its priority problems.

A total of 23 different problems were identified. Prioritizing the problems according to the Hanlon method showed the ten main and priority problems to be, in a descending order, as follows: marriage of girls at an early age (21.01), excessive use of chemical fertilizers in farmlands (20.89), lack of social security clinics (20.51), unemployment (20.38), severe air pollution caused by incineration of industrial waste (20.01), accumulation of municipal waste in the city (19.89), high hardness of city water (19.76), lack of property deeds (19.63), lack of a specific unit in the industrial town to separate waste (19.38), and lack of a gas supply to Mehr Housing and lack of asphalted roads (19.28). Marriage of girls at an early age was identified as the main problem and with the first priority, and a general preliminary study was done on it; it was found that in about 43% of all marriages registered between 2014 and the first half of 2021 the ages of girls were under 18 years. Factors causing and increasing marriage of girls at an early age were identified to be as follows: low awareness of girls' families and girls themselves of the consequences of early marriage, social acceptance of early marriage in the area and low parental literacy.

In this study a wide range of social, cultural, economic and health problems were identified in the population studied. Marriage of girls at an early age is an important social problem with serious undesirable consequences. In an attempt to solve this problem it is essential to consider, in addition to legal and legislative strategies and actions, appropriate scientific, social, cultural and economic strategies and applied research.

It is of utmost importance to identify populations with the elevated risk for Covid-19 and the factors influencing its outcomes. The present study aimed to investigate the factors affecting mortality and length of stay (LOS) in the hospitals of East Azerbaijan Province, Iran, during a 15 months period of this pandemic. Study design: A retrospective study.

This retrospective study was conducted by using data on ISSS (integrated syndromic surveillance system) on the patients admitted to the hospitals from February 21, 2020, to April 11, 2021. The association of variable of interest on death and LOS was investigated via multiple logistic regression and multiple linear regression.

In total, 24,293 inpatients with the mean age of 53.99±19.37 years old were included in this study. About 15% of patients lost their lives. The mean age of the deceased patients was 69.02±14.64 years old and significantly higher than the recovered ones (p<0.001). Aging, male gender and having chronic diseases were correlated with the patient mortality. In addition,   aging and having chronic diseases were associated with higher LOS in hospitals.

The older patients were at a higher risk of mortality and even prolonged hospitalization. In addition, patients’ underlying diseases could cause a severe form of COVID-19 and these individuals were more likely to lose their lives and stay in hospitals for a longer time due to COVID-19.

We aimed to determine the role of demographic, lifestyle, and personality trait factors in predicting control of blood pressure (BP) among patients with hypertension (HTN) in West Azerbaijan, Iran.

In this case control study we recruited participants from all primary health centers of Salmas city; who were at least 18 years of age, had a HTN diagnosis during the previous six months, and had a mandatory household record. Of 490 random subjects approached, 441 (84.2%) fulfilled our inclusion criteria (case: 221; control: 220). The age-matched controls were recruited from the same source population and were required to have controlled HTN. Data were collected through demographic Checklist, Ten-Item Personality Inventory (TIPI) and International Physical Activity Questionnaire (IPAQ).

Upon multivariate analyses, factors related to personality traits subdomains including extraversion personality (odd ratio [OR]: 0.85; CI: 0.73, 0.97) was effective in control of BP. Factors related to uncontrolled BP were agreement and consciences subdomains (OR 1.26 [CI: 1.07, 1.48] and OR 1.21 [CI: 1. 02, 1.44]), rare fruit consumption (OR 5.95 [CI: 1.24, 12.1]), Grade 1 and 2 obesities (OR 2.29 [CI: 1.28, 4.09] and OR 7.11 [CI: 2.21, 12.52]) and smoking (OR 3.27 [CI: 1.56, 6.89]).

In addition to regular physical activity and fruit consumption and quitting smoking; personality traits such as Agreement and conscience personality traits were predictive of HTN control. We believe our work provides the required knowledge to design comprehensive HTN prevention programs by taking into account the multi-level causality approach.

There is limited information on the relationship between family psychological functions and perceived social support with progress in cigarette smoking stages in adolescents. This study was aimed to determine the relationship between family psychological function and perceived social support through a transition in different stages of cigarette smoking in adolescents of Tabriz, Iran.

In this study, 4,216 students (14–19 years old) from high schools were selected by multistage cluster sampling method. Initially, we used valid and reliable questionnaires for demographic characteristics, risk factors, Iranian family psychological function, and perceived social support. The smoking status questionnaire was administered twice, with an interval of 6 months. Data were analyzed using univariate and multivariate logistic regression analysis.

Overall, 3,968 students with the mean (standard deviation) age of 15.96 (0.75) years completed the questionnaire in the first phase of the study. The results showed that lower levels of family psychosocial function (P < 0.001) and perceived social support (P < 0.001) in the univariate state were significantly associated with progress in cigarette smoking stages. By controlling the potential confounding factors, the weak and moderate family psychological function compared to the strong function increased the chance of progress in the cigarette smoking stages by almost 11 and 4 times, respectively (P < 0.001). The low and moderate level of perceived social support compared to the high level increased the chance of progress in cigarette smoking stages by almost 7 and 2 times, respectively (P < 0.001).

It is suggested to perform an organized, precise, and operational planning for strengthening the family psychological functions and providing an appropriate social support condition among adolescents to prevent the tendency toward cigarette smoking and its more advanced phases.

The main objective of this study was to investigate the logics behind tendencies towards bottled drinking water usage in spite of availability of treated tap water. The amount of waste bottle is also estimated in Iran and managing principles for resolving the issue presented.

A questionnaire was used to survey the logics behind tendencies toward bottled drinking water consumption among 120 participants. In order to estimate the quantities of the PET wastes produced in the country, data about bottled water production rate as well as volume of the imported and exported drinking bottled water were collected from 1962 to 2015 and applied in the calculations.

Findings suggested that about 0.026 to 3.86 billion liters (about 1.04 billion liters on average) of bottled water was consumed annually between 2000 and 2015. Furthermore, bottled water consumption increased from 0.41 to 48.9 L/capita-year within the same time period. In the meantime, the plastic bottle waste generation rate rose from 12.84 to 1519.38 g/ capita-year. There is no efficient and suitable system for managing and recycling waste bottles in the country. The perceived unreliability of tap water quality was the main reason of bottled water consumption among 74% of the respondents.

To reduce bottled water consumption and the associated harmful environmental and health consequences, measures such as informing people, validating public water supply quality, preventive rules enactment, and establishing extended producer responsibility (EPR) are highly recommended.

Chronic schizophrenia is a long-term and severe mental disorder. Aerobic exercises can reduce the symptoms of mental disorders, particularly schizophrenia, through improving the patient's quality of life (QoL).

The current study aimed to investigate the effect of aerobic exercise on the QoL of male schizophrenics hospitalized at the Razi Psychiatric Center in Tabriz from 2015 to 2016.

In this randomized controlled trial, 68 patients who met the inclusion criteria were randomly allocated into groups of intervention (n = 34) and control (34). The intervention group has benefited from the aerobic exercise 24 sessions for 8 weeks, 12 hours in total. The control group simultaneously enjoyed the fresh air. The Schizophrenic Quality of Life Scale (SQLS) was completed before and after intervention in both groups. The data were analyzed in SPSS20 using the t-test and chi-squared test.

The mean age of participants was 37.82 ± 7.14 years. No significant differences were found between the demographic characteristics of the two groups. This study showed that no significant difference was found in the quality of life in both groups before intervention (P ≤ 0.37), but there was a significant difference after the intervention (P = 0.001). Aerobic exercises reduce patient's mental disorders and promote their QoL (P < 0.05).

Regular aerobic exercise can reduce the symptoms of male patients with schizophrenics, which in turn improves all dimensions of QoL

There is limited information about the relationship between extraversion, as a personality trait, and the modes of tobacco smoking. The aim of this study was to investigate the relationships between extraversion and cigarette and water‑pipe smoking among a representative sample of Iranian high school students.

A sample of 2,312 tenth‑grade students in Tabriz (Northwest of Iran) was selected through multistage proportional cluster sampling. Participants completed a self‑administered questionnaire including information on cigarette smoking, water‑pipe smoking, extraversion, socioeconomical information, as well as demographic characteristics. An ordinal logistic regression model was used for data analysis.

In total, 4.2% and 3.5% of the students were regular cigarette and water‑pipe smokers, respectively. The adjusted odds ratios were 1.10 (95% CI: 1.04–1.15, P < 0.001) and 1.10 (95% CI: 1.06–1.15, P < 0.001) for the relationships between extraversion and the stages of cigarette smoking and water‑pipe smoking status, respectively.

It seems that extraversion is in a positive relationship with a cigarette and water‑pipe smoking among adolescents. Longitudinal studies are needed to examine the effect of this personality trait on the modes of tobacco smoking and the transition in the stages of cigarette and water‑pipe smoking in adolescents.

Smoking is increasing among adolescents, and family is a factor influencing it. The present study aimed to examine the relationship between transition in smoking stages and parenting styles of parents of adolescents.

This was a longitudinal study in which 3968 high school students in Tabriz, Iran, were examined from November 2017 to June 2018. Sampling was multi-stage, with proportional and random clusters. A questionnaire containing demographic information and potential confounders were filled in by students, and the Parenting Style Inventory was completed by parents only in the first stage. Moreover, students twice (in the beginning of the study and six months later) completed a valid algorithm of stages of cigarette smoking. Data were analyzed using univariate and multivariate logistic regression analysis.

After the six-month interval, 429 students (11.7%) with a 95% Confidence Interval (CI) (10.68 - 12.76) progressed through the stages of smoking. By controlling potential confounding variables, the father’s permissive parenting style compared to the authoritative style increases the odds of progress through the stages of smoking by almost five times (OR=5.06, 95% CI: 2.58 - 9.93), and the father’s authoritarian parenting style compared to the authoritative style increases the odds of progress through the stages of smoking by almost four times (OR=4.01, 95% CI: 2.17 - 7.40).

Inefficient parenting styles are an important risk factor for progress through the stages of cigarette smoking in adolescents. Desirable relationships between parents and children as well as parents’ awareness of parenting styles may prevent smoking in adolescents.

The worldwide trend of hookah use among adolescents is increasing, and literature shows a relationship between obscenity and adolescents’ tendency toward hookah smoking. As there is a lack of appropriate instruments to measure the obscenity of hookah smoking, in the present study, we aimed to develop an instrument to measure hookah smoking obscenity among adolescents.

In this methodological study, a sequential exploratory design was used to conduct the study from February 2017 to July 2018 on adolescents in Tabriz, Iran. In the qualitative phase, we conducted semi-structured individual interviews (with 18 students) and a focus group discussion (FGD) (with 13 students) to explain the concept of obscenity and develop the items of hookah smoking obscenity scale (HSOS). We then examined the psychometric properties of the HSOS based on face, content, construct and predictive validities as well as internal consistency and repeatability.

The HSOS was developed with 21 items based on the results of qualitative data analysis. Applying confirmatory factor analysis (CFA), the χ2/degree of freedom (df) ratio was found to be 3.792 for the four-factor structure of the questionnaire and the fit indices of this structural model were satisfactory. The values of Cronbach’s alpha and the intraclass correlation coefficient (ICC) for the constructs in the HSOS ranged 0.81-0.93 and 0.79-0.92, respectively.

We found the HSOS with a good level of fit indices, validity, and reliability. The HSOS may be applied by school healthcare providers and health practitioners to find valid and reliable data on the obscenity of hookah smoking when developing hookah smoking

Cardiovascular diseases (CVDs), especially ischemic heart diseases (IHDs) are one of the most important health-related issues in the world. Lifestyle plays a remarkable role in preventing or developing such diseases. Therefore, given the importance of lifestyle as an influential factor in the incidence of coronary artery disease (CAD) and the rise of these diseases in younger ages, the aim of the current research was to investigate and compare various aspects of patients" lifestyles on developing CAD and subsequently to contrast them with non-affected patients.

This study included 368 people who were equally divided into four groups of under 45-years-old coronary and non-coronary disease, as well as 45-years and older coronary and non-coronary disease. The participants were selected by means of the convenience sampling method from Madani heart center and Shohada hospital of Tabriz from March to June 2018. Non-coronary and coronary patients were matched in terms of gender and age (±3 years) and data were collected using a 65-item lifestyle questionnaire through interviews.

The mean lifestyle scores were obtained as 103.02 ± 12.11, 123.83 ± 10.35, 99.25 ± 0.27, and 129.02 ± 10.65 for under 45-years-old coronary patients and their counterpart control group, as well as 45-years-old and older patients and their counterpart control group, respectively. Based on the results, there was a significant difference between coronary patients and non-coronary groups in both age categories (P < 0.001). Finally, the comparison of the mean lifestyle scores between the under 45-year-old and the 45-year-old and older groups showed that the two groups only had a significant difference in the subscale physical activity and exercise (P < 0.001) and dietary habits (P = 0.009).

In general, the risk factors for CAD in both age categories were similar except for lower physical activity and nutrition poorer in 45-year- old individuals. Accordingly, primary and secondary prevention, risk factor control, and promotion of a healthy lifestyle at family and society levels should start from childhood and adolescence

Considering the increasing prevalence rate of smoking among Iranian adolescents, and recent evidence on the relationship between obscenity of smoking and tendency of adolescents towards the behavior, there is a need for an appropriate measurement tool to measure the level of obscenity on cigarette smoking among adolescents. This study was conducted to develop a valid and reliable questionnaire for measuring the obscenity of cigarette smoking in adolescents.

This study was conducted in Tabriz, Iran, using an exploratory sequential mixed methods design. To explain the concept of obscenity and develop the questionnaire’s items, 18 students attended semi-structured individual interviews and 13 others took part in focus group discussions (FGDs) in three groups of 4-5. Extracting and summarizing the codes derived from the interviews, an item pool was developed, from which the initial draft of the scale was provided. Next, the psychometric properties of the scale were assessed using face, content, construct, and predictive validity, as well as internal consistency, and reliability in a sample of 1013 high school students.

The 22-item Cigarette Smoking Obscenity Scale (CSOS) was developed based on the codes derived from qualitative data. Explanatory factor analysis revealed five-factor structure (Negative Attitude; Negative Consequence; Negative Valuation; Inappropriate Relationship; A gateway to addiction). In confirmatory factor analysis, the χ2 /df ratio was 3.911 for the CSOS five-factor structure. Suitable values were obtained for the goodness of fit indices (GFI=0.88, AGFI=0.85, NFI=0.87, IFI=0.90, CFI=0.90, RFI=0.85, and RMSEA=0.072). The Cronbach’s alpha and intraclass correlation (ICC) coefficients for the constructs ranged between 0.77 to 0.90 and 0.80 to 0.91, respectively.

The validity and reliability of the CSOS was appropriate; therefore, it can be used in future studies as a suitable tool for measuring the obscenity of cigarette smoking in adolescents.

Disordered sleep occurs frequently in patients who have undergone coronary bypass graft surgery, and it contributes to increased morbidity, mortality, and resource utilization. The present study aimed to determine the effects of deep-breathing exercises on postoperative sleep duration and quality in patients undergoing coronary artery bypass graft.

This study was a clinical trial. The study sample included 64 patients who were coronary artery bypass graft hospitalized from January 2015 to April 2015 in Qazvin Booali-Sina hospital. The patients were selected by convenient sampling and then the participants were randomly allocated to the intervention and control groups. The baseline and postoperative (day 7) sleep duration and quality metrics were measured. The St Mary's Hospital Sleep Questionnaire was used to evaluate sleep quality in two groups.

Baseline night sleep duration was 5.72 (1.63) hours in the control group and 5.58 (1.07) hours in the intervention group. The initial findings showed that the mean of sleep quality score of patients in the intervention and control groups were 19.72 (2.68) and 18.22 (3.81) respectively. These measurements did not decline postoperatively in the intervention group while night sleep duration and quality declined in the control group. Deep breathing exercise program had a significant effect on sleep quality score in the intervention group compared to the control group.

The results indicated that deep breathing exercises prevent decline in sleep quality postoperatively. It seems to be a safe method with no side effects for these patients. Furthermore, it is a simple method to implement and does not impose a high cost.

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.

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.

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.

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.

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.

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.

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.

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.

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. 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. 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. 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.

Noise-induced hearing loss (NIHL) is one of the most important public health problems. There is scant information about NIHL, the prevalence and using patterns of headphones and music player devices in Iran. This study aimed to assess the prevalence and using patterns of earphones and investigate the relationship between earphone use and hearing loss in a sample of students from Qazvin University of Medical Sciences (QUMS). In this cross-sectional study, 890 students were randomly selected using a proportional cluster sampling method in April and May 2015. The students completed a self-administered questionnaire assessing the pattern of their earphone use and hearing loss. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off point for the questionnaire. The results suggested that 60.2% (95% confidence interval (CI): 56.9 - 66.4) of the students reported a history of hearing loss and hearing impairment and 86.4% (95% CI: 84.0 - 88.5) of the participants reported using an earphone in the past. Most of the participants listened to music on their cell phones (81.7%) and 89.6% of them used headphones for listening to music. The results indicated that 51.3% of those who used earphones used earbud-style earphones, 42.2% used supra-aural earphones, and 6.5% used headphones. Students who used earphones, those who used earphones more frequently during the week, and those who used earphones for more years had higher hearing loss scores compared to other students. Students have a risky pattern of using personal listening devices. The higher hearing loss score among headphone users requires further attention in order to implement interventions to increase students’ awareness and attitude towards the use of headphones.

Adolescent smoking status were powerful predictors for adult smoking where the most people who started smoking at lower ages continueed to smoke later. The smoking process is complicated and is not limited to smokers and non-smokers, but includes patterns and different stages that need to be identified and evaluated . The main objectives of the current study is to identify stages of smoking in adolescents and to assess factors influencing the patterns of smoking in this population. Using the multistage random sampling, 56 high schools with a total of 205 classrooms were randomly selected. The total number of 4907 high school students in Tabriz, Iran participated in the current study and completed a self-administered questionnaire. Multilevel latent class analysis was used in smoking stage determination. Three stages of smoking were identified non-smokers, moderate, and heavy smokers with prevalence 71.3%, 22.4%, and 6.3%, respectively. In gender specific analysis, such figures were 82.6%, 14.5%, and 2.7% for girls and 77.3%, 15.6%, and 7% for boys, respectively. Age, the grade point average, living with parents, having smoking friends and family, risk taking behaviors, self-injury, attitude and positive thinking about smoking were significantly associated with smoking stages in students. The social-economic status did not have significant association with smoking stage. Using multilevel classification technique that consider the hierarchal construct of data, a more reliable stages of smoking was measured in male and female adolescents.

Developing appropriate programs for community problem solving and community development and prosperity will be possible only after realistic identification of the community’s problems. Community health assessment is a process by which researchers and community members understand the health care system and community concerns through data collection and analysis, determining strengths and weaknesses and defining the community’s resources and demands. Basmenj is a town located 10 kilometer from the metropolitan City of Tabriz, Iran and on the verge of adjoining this metropolis. This paper reports results of the community assessment of this town. This study was conducted in autumn 2017. The methodology used for community assessment was based on the eight-stage model of North Carolina. In the first seven stages the Basmenj community problems were identified and prioritized, followed, in the eighth stage, by developing an action plan for solving the problems in order of priority. Approximately 100 different problems were identified at the end of the first stage. Based on the Hanlon classification model, the top prioritized problems of the region were found to be, in that order, youth addiction, urban trashes, stray dogs, environmental pollution caused by Pars Color Company, narrowness of the main street, inner-city livestock farming, early marriage among girls, wastewater problems, youth unemployment, and high consumption and self-administration of anti-biotics.
From among these problems, the urban trashes problem was studied briefly. Factors playing a role in its causation were found to be as follows: lack of waste reduction and waste sorting programs, low citizens’ knowledge about trash gathering, absence of an appropriate urbane wastewater system, and, finally, lack of participation of citizens and the private sector in trash gathering and burying A wide range of social, cultural and economic problems was identified. The top priority was found to be focusing on problems related to urban trashes. However, it should be noted that solving all the community problems identified requires the co-operation and support of all the governmental organizations, as well as involvement of the community at large.

We decided to assess the correlation between metabolic syndrome (MetS) risks,sleep and napping duration in Azar cohort population according to the increasing incidence of MetS in the world and inconsistence results about sleep duration and MetS. In this cross-sectional study, MetS and sleep habits of 14916 subjects (35-70 years old) who inhabited in Shabestar city were determined by ATPIII and Pittsburg questionnaire respectively. Inclusion criteria were subjects with 35-70 years old and living in Shabestar for at least 9 months of the year. According to the results, age, living place, body mass index, hypnotic drug use, sleep and napping duration and TV time were the risk factors of MetS. In this regard, long sleep duration (>9 h/24 h), napping (0.25-2 h/day), hypnotic drug use and watching TV (2 h/day)increased the risk of MetS by 1.18 (1.05-1.33), 1.16(1.07-1.26), 1.35(1.13-1.60), and 1.13(1.04-1.23) respectively. According to these results, it appears that proper education for improvement of sleep habit is necessary to reduce incidence of MetS and its consequences. However, there is need for more longitudinal researches and using objective method of sleep habits evaluation for more precise results

According to the World Health Organization’s report, tobacco use is the first preventable leading cause of deaths in the world.While the prevalence of tobacco use is declining in high-income countries, this prevalence is increasing in the low-income and middle-income countries. Daily, 205 thousand USD and 386 million USD annually spent on cigarette purchasing in Iran, and the health system of the country pays about 1 billion and one hundred and sixty million USD to cure the complications of cigarette smoking. The present study aimed at determination of effective programs and interventions applied in prevention and reduction of tobacco use in societies. Medical databases were searched, related studies retrieved and their content reviewed and classified. According to the results of this study, programs and interventions for prevention and reduction of tobacco use were categorized in six domains including: "studies at different levels of age and groups," "studies in the physical and community environment," "tax and price studies," "electronic cigarette smoking studies," "harm reduction studies," and "interventions facilitating solutions." The results of the study, suggests the followings as appropriate strategies that fit the culture and abilities of the Iranian health system: "culture, the establishment and application of rules", "interventions with a focus on specific groups", "education at all levels and interventions," "organizing training courses and emphasizing the role of the family in protecting adolescents" and “free drug therapy ".