Predicting Tobacco Smoking Among Male Adolescents in Hamadan City, West of Iran in 2014: An Application of the Prototype Willingness Model

Background: As adolescent tobacco smoking has become a widespread problem in developing countries, it is time to understand the cognitive determinants of adolescentsʹ decisions to engage in tobacco smoking. This study aimed to investigate the predicting factors associated with tobacco smoking among male adolescents based on Prototype Willingness Model (PWM) as a theoretical framework. Methods: This descriptive-analytical study was carried out on 810 male adolescents of Hamadan City western Iran, recruited with a multistage sampling method. The data-gathering tool consisted of a questionnaire based on the PWM constructs. Data analysis was performed using SPSS-19 software, by bivariate correlations, liner and logistic regression tests. Results: The prevalence of current tobacco smoking was 17.2%. Behavioral willingness and subjective norms were the most important predictors of behavioral intentions, whereas subjective norms, attitude and prototype were the most important predictors for behavioral willingness. The result obtained from logistic regression analysis revealed that both pathways of PWM constructs [behavioral intention (OR=1.207; 95% CI: 1.13, 1.28) and behavioral willingness (OR=1.334; 95% CI: 1.25, 1.41) were significant predicting factors for tobacco smoking among male adolescents. Conclusions: The framework of the PWM is applicable and useful in understanding tobacco smoking among male adolescents. In addition, the results revealed the importance of social reaction path when examining adolescentsʹ smoking status.