Reasons for Smoking among Male Teenagers in Tehran, Iran: Two Case-Control Studies Using Snowball Sampling

Objectives: identifying the underlying factors contributing to smoking among teenagers is important in establishing smoking control programs. the present study was designed to identify and compare factors revealed in a preceding qualitative study con- ducted on 13-15 year-old boys living in two different socio- economic districts in the northern and southern parts of tehran. methods: two completely similar case-control studies, each with 200 subjects, were conducted using a snowball sampling. the case and control subjects were matched based on the intimacy rela- tions, i.e. six smokers were recruited in each of the northern and southern districts; they were then asked to introduce one of their smoker friends as a case and a non-smoker one as a control. results: multi-variable conditional logistic regression revealed that having a smoker father is the single effective factor in the two districts. as for boys living in the northern (wealthier) part of the city, social capital (or: 0.59, 95% ci: 0.43-0.81) played a protec- tive role against smoking, whereas quitting home after a quarrel (or: 15.07, 95% ci: 1.54-147.25), monthly allowance (or: 2.22, 95% ci: 1.29-3.82) and hyperactivity (or: 1.69, 95% ci: 2.64- 240.45) were associated with a higher risk of becoming a smoker. conclusions: the studied variables can be classified as personal, familial, and school-level factors. familial intervention is effective for all the factors which revealed to be influential on the risk of becoming a smoker. it could be concluded that interventions on the family level should be used to prevent the cigarette use in te- hran.