Determinants Number of Cigarette Smoked with Iranian Adolescents: A Multilevel Zero Inflated Poisson Regression Model

The present study was conducted to know about the association between amount of smoking and mental health plus demographic factors in the Iranian adolescents. Data of this research was drawn from the National Health Survey in Iran from April 1999-March 2000. All 1745 ado lescents aged 15-20 yr that were residence in the eight northwest provinces of Iran, were included in this study. In order to evident zero-inflation and because of sampling design, multilevel zero-inflated Poisson (ZIP) regression applied for analy sis of data. We analyzed data with programs written with s-plus. Zero-inflated part of ZIP model shows that gender of female effects to increase the chance of "not to smoke ciga rette at all" (P< 0.001) and older adolescents are less at risk of smoking than younger (P= 0.036). It also shows that, unem ployed (P= 0.028) and Housewife (P= 0. 003), adolescents are more at risk of smoking compare with student adolescents. Un der Poisson part of this model, depression (P= 0.012) and gender of female (P< 0.001) are indirectly associated with num ber of cigarette smoked per day by adolescents. Among adolescent smokers, males smoke more number of cigarettes than females, younger teenager are more at risk of being a smoker than older ones and dropping out of high school is an important risk factor for smoking. We did not find any relation between mental disorders and being a smoker while we did for the relation between Number of Smoked Cigarette (NSC) and depression.