Water Pipe Smoking Reduction in the Male Adolescent Students: An Educational Intervention Using Multi-Theory Model

Saeed Bashirian, Majid Barati, Manoj Sharma, Hamid Abasi, Manoochehr Karami


Background: Water pipe smoking (WPS) has increased and is becoming a major leisure pastime among young people in Iran. The aim of this study was to determine of efficacy of an educational intervention based on Multi-Theory Model (MTM) to reduce WPS in the male adolescent students in Iran.

Study design: A randomized controlled trial.

Methods: Overall, 94 male adolescent students (grades 10, 11) smoked water pipe (WP) in the past month (current WP smokers) were selected, allocated randomly in two groups (47 students in intervention group and 47 students in control group), in two different schools in 2018 in Hamadan City, western Iran. Data were collected utilizing a valid and reliable questionnaire based on MTM constructs and demographic variables. Educational intervention was designed in five 45-min sessions. Two groups were followed-up three-months after completion of intervention. The collected data were analyzed using SPSS 22 software through Chi-square test, independent-sample t-test, paired-samples t-test, and Friedman test.

Results: There were significant differences between the mean score of participatory dialogue, behavioral confidence, emotional transformation and practice for change in the intervention group compared with the control group after the intervention (P<0.001). In addition, significant reductions in the frequency of WPS (from 14.9% to 4.3%) were observed in the intervention group compared to the control group (P<0.001).

Conclusion: The developed educational intervention based on MTM constructs was efficacious and can be replicated for effectiveness studies to reduce WPS in the male adolescent students in Iran.


Water pipe smoking; Smoking reduction; Health behavior; Students; Adolescent

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