Cigarette smoking patterns in relation to religiosity and familial support among Iranian university students: A Latent Class Analysis

INTRODUCTION: Entering University is an important developmental milestone that might be associated with cigarette smoking. The aim of this study was to identify the subgroups of university students on the basis of cigarette smoking patterns, and to assess the role of familial support and religious beliefs on membership in specific subgroups. METHODS: This cross-sectional study was performed in 2016 using multistage random sampling among students of Bushehr University (n=977). Anonymous, structured questionnaires were distributed to the students in each selected class. Cigarette smoking prevalence was assessed in three time intervals: lifetime, last year, and last month. All of the analyses were performed using PROC LCA in the SAS software. RESULTS: The lifetime, last-year and last-month prevalence of cigarette smoking was 13.7%, 10.0% and 7.0%, respectively. In this study, the prevalence of passive smoking was relatively high (15.3%) among students. Four latent classes were identified: 1) non-smoker 58.2%, 2) passive smoker 31.3%, 3) moderate smoker 3.4%, and 4) heavy smoker 7.1%. The prevalence of cigarette smoking of close friends was: 73% among passive smokers, 81% for heavy smokers and 63% for moderate smokers. Being male (OR=4.42, 95% CI; 2.90–6.74) and a higher score of religious beliefs (OR=0.97, p<0.001 95% CI; 0.96–0.98) were associated with the heavy smoker class. CONCLUSIONS: Among students at Bushehr University in Iran, 10.5% were either moderate or heavy smokers in 2016. These results point out the critical importance of designing specific preventive interventional programs for university students. Higher level of religiosity may serve as a preventive factor in engaging in cigarette smoking.