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J Educ Health Promot. 2014 Feb 21;3:23. doi: 10.4103/2277-9531.127614. eCollection 2014.

Factors affecting cigarette smoking based on health-belief model structures in pre-university students in Isfahan, Iran.

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Departments of Health Education and Promotion, Isfahan University of Medical Sciences, Isfahan, Iran.
Public Health Department, Golestan University of Medical Sciences, Golestan, Iran.
Department of Public Health, School of Health, and Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.



The goal of this study was to determine the association between constructs of the Health Belief Model (HBM) (i.e., perceived susceptibility to health-related problems due to smoking, perceived barriers to non-smoking, perceived benefits of non-smoking, perceived self-efficacy to non-smoking, and cues to action of non-smoking) and cigarette smoking among male pre-college students.


A cross-sectional survey of 382 pre-college students was conducted in Isfahan, in 2010. The method of sampling was systematic randomized and students were selected from eight schools. The instrument was developed by the researchers based on the Health Belief Model. Statistical analyses were carried out using SPSS.V.18, Chi-square, and independent t-tests.


The mean age of the students was 17.72 ± 0.62 years. Overall 7.2% of the subjects reported having smoked in the past 30 days and 32.7% % of the samples reported ever having smoked in their life time. Results of the t-test showed that there were significant differences in knowledge, perceived susceptibility (P =0.03), benefits (t (246) = -2.51, P =0.01), self-efficacy (P < 0.001), and cues to action (P = 0.007), between smokers and non-smokers.


These results suggested that the constructs of HBM can be incorporated when examining the predictors of cigarette smoking and developing smoking prevention programs among pre-college students. Furthermore, with a better understanding of the factors affecting this complex behavior (cigarette smoking), it can be a useful step to reduce the rate of death, costs, and also improve the community health outcomes.


Cigarette smoking; health belief model; students

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