The Correlation of Student's Smoking and Their Perceived Exposure to Their Teacher's Smoking in Tehran: A Population Based Study

Introduction: Smoking approval by friends and teachers seems to increase the probability of smoking by the students. This study aimed to determine whether adolescent smoking is associated with teachers or other students smoking, after controlling for confounders. Methods: A sample of the 3rd grade students of Tehran's high schools were asked to complete a 21 item questionnaire, including demographic and smoking habits. The comparisons of adolescent smoking pattern between two sexes and also smoking frequency of the family members, best friends and teachers between the smoking and non-smoking students, were performed. Furthermore, the association between smoking behavior and exposure to teachers smoking were assessed by a multivariate logistic regression analysis, adjusted for sex, parental, best friends, and sibling smoking. Odds Ratios were estimated. Results: Among the 4591 students (aged 17-19, mean 17.53±0.59 years), including 2092 boys (45.6%) and girls, 250 boys (12.1%) and 131 girls (5.3%) were current smokers (p=0.001). The proportion of smoker and non-smoker students who have been exposed to teachers smoking inside the school building were 55.7% (209) and 29.3% (1191) respectively (p=0.001). The 220 (58.7%) exposed students to outdoors teachers smoking (on school premises) were smoker while 1205 (29.2%) were non-smoker (p=0.001). By adjustment of the parameters, adolescent exposure to best friend smoking and to teachers smoking on school premises was significantly associated with current smoking. Conclusion: Teachers smoking during school hours and best friend smoking are the two important determinants to be considered in any project aiming to establish tobacco-free schools