Survey of the relationship between extroversion and transition in cigarette and water‑pipe smoking stages in high school students in Tabriz- A longitudinal study

Abstract

Background and objectives: Smoking is a major public health problem that specifically affects the adolescent population. Most adults who smoke start this habit in adolescence. Starting smoking is in several stages. This study aimed to investigate the relationship between extraversion and transition in smoking stages and progress in the stages of water pipe use in high school students in Tabriz city. Method and material: A sample of 2256 tenth‑grade high school students in Tabriz was studied in two steps. A multistage cluster sampling method was used for sampling. In the first step, the demographic characteristics, smoking, and water‑pipe smoking status, and Eiseng's extraversion questionnaire were completed by all students in the selected schools, and 8 months later, cigarette and water‑pipe smoking status was assessed again to determine transition in cigarette and water‑pipe smoking stages. The total transition rate in the cigarette smoking stages and progression in the water‑pipe smoking stages were compared between the two groups of extraversion and introversion. Cluster analysis was used for all analyses and for data analysis, Chi-square, one-way ANOVA, and logistic regression models were used, which these analyses performed with Stata-14 software. Results: The results of the first phase of the study showed that 4.2% and 3.5% of the students were regular cigarette smokers and regular water‑pipe smokers, respectively. The adjusted odds ratio for the relationship between extraversion score and smoking stages and water‑pipe smoking was 1.01 (95% confidence interval: 1.04-1.15, P <0.001) and 1.10 (confidence interval 95 %: 1.06-1.15, P <0.001). Therefore, there was a significant relationship between extraversion score and smoking stages and water‑pipe smoking. The results of the second stage showed that 7.2% and 6.9% of the students were regular smokers and water‑pipes, respectively. 10.4% of introverts and 10% of extraverts had passed the stages of smoking from time 1 to time 2, which was not statistically significant (P-value = 0.850). Additionally, 9% of introverts and 10.7% of extraverts from time 1 to time 2 had progress in water‑pipe use stages, which was not statistically significant (P-value = 0.347). Conclusion: The results of this study showed that, although extravert students had more cigarette and water‑pipe smoking than introvert students, the transition rate in cigarette smoking stages and water‑pipe smoking status was the same in the two groups.