The Prevalence and ۵-Year Incidence Rate of Cigarette Smoking and Water-Pipe Tobacco Smoking and Their Associated Factors among ۱۵ to ۸۰ Years Old Urban Population in Southeast Iran: Results from KERCADR Study

Background: Cigarette and tobacco smoking are closely associated with chronic cardiovascular disease and lung cancer. We aimed to assess the prevalence and ۵-year incidence rate (IR) of these two risk factors for cardiovascular diseases in Kerman, southeastern of Iran.Methods: ۱۰۰۱۵ individuals aged ۱۵-۸۰ were recruited to the study between ۲۰۱۴ and ۲۰۱۸ (Kerman coronary artery disease (CAD) risk factors study, KERCADRS) of which ۲۸۲۰ had also participated in the first phase (۵ years earlier). We took fasting blood samples and collected demographic information and data on cigarette and water-pipe tobacco smoking (WPTS) through interviews. Findings: The overall prevalence of cigarette smoking increased from ۸.۱% in phase۱ to ۸.۸% in phase ۲. During the same period, the prevalence of WPTS increased from ۱۰% to ۱۴%, especially in the age groups of ۱۵-۴۵ years. The prevalence of opium dependance was higher among cigarette smokers compared to WPT users. The overall ۵-year IR of cigarette and WPTS was ۳.۶ and ۴.۶۵ per ۱۰۰۰ person-years respectively. The highest IRs of cigarette smoking and WPTS were reported in the age group of ۱۵-۳۹ years, and IR of WPTS was higher among women. Obesity, diabetes, and hypertension associated with a reduced IRs of cigarette and WPTS. Conclusion: Over the past five years, the prevalence of cigarette smoking has increased slightly, but WPTS has increased more rapidly, especially among women. The highest prevalence of cigarette and WPT smoking was in the age groups of ۱۵-۳۹ years. Smoking is shifting from cigarette smoking to WPTS. Age- and gender-oriented interventions would help correct the unhealthy life style in the community and prevent further smoking-related morbidities and mortalities.