Abstract
Background: Smoking is a major public health problem that specifically affects the adolescent population health and future. This study aimed to investigate the relationship between extroversion and transition in cigarette and hookah smoking stages in high school students in Tabriz city.Methods: A sample of 2256 high school students aged 15-16 years old in Tabriz was included in the study. Demographic characteristics, cigarette, and hookah smoking status, and Eysenck’s extroversion questionnaires were completed by all students in the selected schools. Eight months later, cigarette and hookah smoking status was assessed again to determine transition in smoking stages. Marginal Homogeneity test was used to compare the smoking status at the beginning and eight months later. The Generalized Estimating Equation method with the ordinal link was applied to estimate the effect of extroversion on transition in smoking stages.Results: The mean (SD) age of the students participating in the study was 15.5 (0.5) years old. Marginal homogeneity test results show that, in general, transmission in the stages of both cigarette and hookah smoking in eight months was significant in students (P-Value <0.0001). Extrovert personality had a significant positive effect on the transition from lower stages to higher cigarette and hookah smoking stages according to GEE with ordinal link (P<0.0001). In cigarette and hookah smoking, extrovert persons transited to higher stages 1.56 and 1.68 times than introvert persons.Conclusions: Being an extrovert person had a significant effect in the transitioning to higher stages of smoking cigarettes and hookah.