The prevalence of smoking among Iranian middle school students, a systematic review

The mean age of cigarette smoking has decreased along with an increase in its prevalence, in developing countries. The aim of this systematic review is to determine the prevalence of lifetime, current and daily smoking among middle school students in Iran. Various search methods have been used in this study including searching different international databanks such as Pubmed, ISI web of Science, PsychInfo, CINAHL, Embase, as well as domestic databanks including IranPsych and IranMedex. All original studies and researches in Persian or English, which had described any kind of use including lifetime, current and daily use of cigarette, hookah, and pipe among middle school students, were included in the study with no restriction on date of publication, and were qualitatively assessed. Subsequent to data extraction, heterogeneity test was carried out on indicators for which more than two studies were found, and meta-analysis was done using random effects model. The combined prevalence of lifetime, current and daily cigarette smoking were calculated as 14.2% (95% CI: 6.6-21.7), 2.7% (95% CI: 0.5- 5.9) and 1.1% (95% CI: 0.6-2.8), respectively. The combined prevalence of "current tobacco use of all kinds" was 15% (95% CI: 10.4-19.5), as well. The prevalence of smoking in this age range is lower in Iran compared to other countries. However, a conclusion cannot be made about the changes in the prevalence of smoking in recent years. Moreover, studies carried out to the present have several qualitative limitations, which points to the necessity of high quality repeated surveys