Smoking Behavior Among Students: Using HBM and ZIOP Model
Abstract Background The purpose of this study was to explore the predictors of smoking among high school students using health belief model (HBM). Methods In this cross-sectional study, participants were 425 boys (mean age was 16.7 ± 0.85 and ranged from 15 to 19 years) among high school students in Bandar-Abbas city. Data were collected using a researcher-made questionnaire consisted of two main sections: Socio-demographic characteristics and HBM constructs. The zero-inflated ordered probit (ZIOP) model was used for investigating the association between health belief model constructs and smoking behavior. Results Results indicated that 82% of participants never smoked cigarette at all. The results of ZIOP model showed that knowledge, susceptibility, severity, benefits and cues to action had significant effect (P < 0.05) on smoking cigarette after adjusting for other covariates (i.e age, parents’ education, losing one of the parents). Moreover, having a smoker friend was an inflation factor (P < 0.001). Adolescents with smoking friends are 44% less likely not to smoke at all. Conclusion Based on these findings, having a smoker friend, knowledge, susceptibility, severity, benefits and cues to action have a key role in predicting smoking and should be considered in designing educational programs aiming at reducing smoking initiation among adolescents.