Survey of the effect of increasing of self-esteem and communication skills on prevention of the transition in smoking stages among high school students in Tabriz city

Abstract

Background and objectives: Cigarette smoking continues to be a major public health problem that specifically affects the adolescent population. The aim of this study was to investigate the effect of enhancing of self-esteem and communication skills to prevent of transition in cigarette smoking stages in high school students in Tabriz city. Method and material: This study was conducted in 1225 high school students in Tabriz city in 3 phases in 2017. Initially two districts from the 5 educational districts were selected by non-random method then 9 high schools (44 classes) were selected and divided into two groups of intervention and control by simple random method (526 students in the intervention group and 699 students in the control group). At first, all 10th grade students in these schools completed a questionnaire on demographic characteristics, smoking status, self-esteem and communication skills. Then, in the intervention schools, the educational program to enhancing self-esteem and communication skills were implemented and at the end of the training sessions, the self-esteem and communication skills questionnaires were completed in both intervention and control groups. Finally, about 8 months later, the student completed the study questionnaire again to determine the transition in cigarette smoking stages and change in self-esteem and communication skills scores. Analysis of variance for repeated measures was used to determine the effect of program on enhancing of self-esteem and communication skills and logistic regression model was used to assess the effect of program on transition in smoking stages. Results: The results of the study indicated that there was a negative relationship between self-esteem and smoking stages, the higher self-esteem score the lower probability of being in advanced smoking stages. The results indicated that the self-esteem and communication skills scores of intervention group increased over time but it was not statistically significant. There was no difference in the transition in smoking stages between two groups. The results of logistic regression model also indicated after adjustment on potential confounders such as gender and socio-economic status, living with parents and attitude toward smoking there was no difference in the transition in smoking stages between two groups (Odds Ratio=0.77, 95% confidence interval: 0.42-1.38, P= 0.379). Conclusion: Regarding the low effect of intervention program on self-esteem and communication skills, we cannot comment on the effect of enhancing of self-esteem and communication skills to prevent of transition in cigarette smoking stages in the adolescents.