Predicting to reduce water pipe smoking in male adolescents: using multi theory model (MTM)

Background: Water pipe (WP) smoking has increased and become a major leisure pastime among young people in Iran. The aim of this study was to test MTM in its ability to predict reducing WP smoking in male adolescents. Methods: This cross-sectional study was performed with730 high school male students (grades 10-12), who were recruited through multi-stage random sampling in Hamadan city in Western Iran in 2017. We included 200 students who had smoked WP in the 30 past days (current smoker) determined by a screening question. The self-administered questionnaire included information on demographic variables and MTM constructs related to WP smoking. The questionnaire had acceptable validity and reliability. Results: The regression analysis revealed that 35.7% of the variance in initiating reducing WP smoking behavior was predicted by participatory dialog (p < .001) and behavioral confidence (p < .001). Sustenance of reducing WP smoking behavior was predicted up to 13.5% by emotional transformation (p < .001), practice for change (p < .05) and changes in the social environment (p < .05). Conclusions: MTM appears to be a robust theory in its application for reducing WP smoking. This theory must be reified and empirically tested with intervention development for WP smoking behavior in male students. Abbreviations: MTM: Multi-Theory Model; WP: Water pipe