Predictors of Smoking Preventive Behavior Based on Empowerment Components among Male Students of High Schools: A Cross-Sectional Study in Iran

BACKGROUND: Smoking among adolescents and young adults is believed to be one of the most important preventable health problems. The etiology of smoking is one of the most pivotal activities in designing prevention programs. The aim of this study was to determine the correlates between components of empowerment in the context of smoking prevention in adolescents. METHODS: This cross-sectional descriptive study was carried out on 422 high school male students in spring 2020. The data collection tool of this study was a valid and reliable researcher-made questionnaire containing demographic characteristics, items related to various components of empowerment, and items related to the smoking preventive behavior (SPB). A linear regression model was used, where the “SPB” outcome variable assumed three possible values: sensation seeking, problem-solving skills, self-efficacy, self-esteem, dependence on group, and attitude towards smoking reported in the previous literature were taken as independent variables, and smoking preventive behavior was considered as a dependent variable. RESULTS: The results revealed that 10.42% of the students were active smokers and 40.75% of them had the experience of smoking. The results also showed a positive and significant relationship between problem-solving skills (r = 0.394, P < 0.001), self-efficacy (r = 0.340, P < 0.001), self-esteem (r = 0.310, P < 0.001), and attitude (r = 0.333, P < 0.001) with the SPB. In addition, a negative and significant correlation was observed between group dependence (r = -0.313, P < 0.001) and the SPB. Overall, the components of empowerment were able to explain 26.5% of the variance in the SPB. Among the components, problem-solving skills solely explained 15.5% of variance of the SPB. CONCLUSION: According to the results of this study, it can be said that most adolescents are at risk of smoking. Explanatory factors for adopting the SPB include improving problem-solving skills, creating a negative attitude towards smoking, increasing self-efficacy to prevent smoking, reducing group dependence, and increasing self-esteem in adolescents. Multilevel interventions and actions by policymakers, educators, and related organizations to prevent adolescent smoking and educate them about adolescent empowerment skills to prevent smoking should be considered.