@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2020;7(1):13-21

Background
… [1]. Hookah is a traditional type of smoking and one of the major public health challenges and one of the leading causes of death in most countries [2, 3].
Previous Studies
... [4-19]. It has shown that the pattern of tobacco use is associated with complex socio-structural processes, including low socioeconomic status, peer pressure, attitudes, abstract norms, intention, and self-efficacy as the most important predictors of smoking in adolescents. These factors are the components of the Theory of Planned Behavior (TPB), and according to the global studies, among available theories, TPB is the most useful theory to better understanding the predictors of tobacco use [20]. ... [21]. Many studies have used TPB for tobacco use, including Fathi et al. [22], Jovini et al. [23], Jahanpour et al. [24], and Mohammadi Zeidi et al. [25].
Aim(s)
The purpose of this study was to investigate the effect of an educational intervention based on TPB on the prevention of hookah smoking among high school students.
Research type
The present research was a quasi-experimental study
Research society, place and time
This study was performed on high school male students (second and third grade) in Fasa city in 2018-19.
Sampling method and number
A study by Alzio et al. [12] found that 5.3% of adolescents were hookah users. Thus, at least 200 individuals in each group are needed to make a significant difference of 0.63% between the two groups with 95% accuracy and 80% power based on the sample size determination formula in clinical trials. Samples were randomly divided into the control (n = 200) and experimental (n = 200) groups.
Used devices&materials
The data collection tool was a self-reported questionnaire consisting of demographic information and TPB parts. The questionnaire was completed by the experimental and control groups before and three months after the intervention. The educational intervention consisted of seven 50-55-min training sessions and one session per week for the experimental group in high school classroom. Life skill training was used in the TPB-based intervention. The sessions were held in groups of 20 subjects in the classrooms focusing on group discussion techniques, role playing, and brainstorming and the role of friends and their support, as well as the ability to say no and avoidance of friendships with hookah users were pointed. A summary of the discussed subjects was given to the students the end of each session (abstract norms and behavior). At the end of the training sessions, educational booklets were given to the subjects. To follow-up the activities, a training session was monthly held for the students and a WhatsApp group was formed to exchange information with the parents of the students Data were collected before and 3 months after the intervention and were analyzed by SPSS 22 software using paired t-test, independent T-test, and chi-square test.
Findings by Text
The mean age in the experimental and control groups were 16.±1 1.68 and 16.54 ± 1.33 years, respectively. Also, the number of family members in the experimental and control groups were3.88 ± 2.58 and3.64 ± 2.72, respectively, which there was no significant difference between the two groups (p> 0.05). There was no significant difference between the students of the experimental and control groups in terms of other demographic variables, including educational level, household monthly income, parents 'educational level, parents' occupation, and smoking hookah, cigarettes or drugs in parents (p> 0.05; Table 2).Before the educational intervention, there was no significant difference between the experimental and control groups in awareness, attitude, abstract norms, perceived behavioral control, intention and preventive behaviors of hookah smoking (p> 0.05); however, three months after the intervention, the experimental group showed a significant increase in each of these variables (p = 0.001), while in the control group there was no significant difference (p> 0.05; Table 3).
Main comparison to the similar studies
... [26-30]. Mackundy et al. examined factors related to hookah smoking on 5 students based on the TPB and showed that positive attitude and perceived behavioral control were the strongest predictors of hookah consumption [27]. ... [31, 32]. In the study by Arab et al., smoking friends, smoking parents, and smoking siblings were associated with tobacco use. In this study, among the constructs of TPB, abstract norms construct was the most important preventers of tobacco use among students [33]. Khani Jeyhouni et al. also cited the lack of contact with hookah friends as one of the most important reasons for non-smoking hookah [30]. In other studies consistent with the results of this study, educational intervention increased the mean score of abstract norms [15, 34]. ... [35]. In a study by Alamy et al., perceived behavioral control was a strong predictor of intention to prevent tobacco use in college students [36]. In studies conducted by Makvandi et al. [27], Karimi et al. [35], Tahmasebi et al. [37] and Alanazi et al. [38], perceived behavioral control and attitude were the strongest predictors of hookah and cigarettes. The findings of other studies indicated an increase in the perceived behavioral control score after the intervention [41-41] .... [42-44].
Suggestions
It is recommended that the institution officials by cultivating via effective methods educate students and their families, develop daring skills, and plan for reducing smoking.
Limitations
One of the limitations of this study was self-reported data collection.
Conclusions
The TPB-based educational intervention is effective in preventing hookah smoking in high school students.
Acknowledgments
The authors are thankful to all those who contributed to this research.
Conflict of interest
None.
Ethical Permissions
The study was approved by the Research Council of Fasa University of Medical Sciences (Ethics code: IR.FUMS.REC.1396.305).
Funding Sources
This study was sponsored by the Vice chancellor for research of Fasa University of Medical Sciences (Grant No.: 96218).

TABLES and CHARTS

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