Smoking behavior can be considered a serious and dangerous factor in society, and its major consequences include the destruction of efficient human resources and the creation of obstacles to human, social, cultural, and economic development.1 Extensive use of tobacco is considered a health and epidemic problem in adolescents.2
The World Health Organization(WHO) estimates that 8 million people die each year from tobacco-related diseases by 2020.3 The WHO emphasizes that if the current trend of smoking continues, by 2030 the number of victims will be 10 million4, 70% of which will occur worldwide in developing countries.5
Smoking causes 90% of lung cancers, 40% of other cancers, 75% of respiratory diseases, 50% of cardiovascular diseases and 12% of all deaths.6 More than $ 150 billion is spent annually on health problems caused by smoking.7 Despite the fact that the harms of smoking have been well established, many adolescents are still interested in smoking.8 The age of onset of smoking has decreased in developed as well as developing countries9 and approximately 90% of smokers experienced smoking at younger ages.10 The lower the age of onset of smoking, the more dependent it is and ultimately the stability of smoking.11
The prevalence of smoking in different parts of the world varies from 14.2 to 39 percent.12,13 In Iran, the prevalence of smoking is 9.2 to 28.8 percent, which is estimated to be 14.2 percent in student adolescents.14 Adolescence is a critical period of development because during this period many positive health behaviors (such as diet and exercise) and dangerous health behaviors (such as smoking and alcohol consumption) are formed.15 One of the most important requirements for a country to achieve economic, social and political progress and stability is to pay attention to the health and developmental needs of this age group.16
One of the concerns of health / social policymakers in today's society is the increasing prevalence of addictive behaviors, especially smoking addiction in adolescents.17,18,19
Cigarette addiction treatment is expensive and difficult, and requires a variety of treatment approaches, such as medication and psychotherapy. However, even the most effective treatments are associated with a high rate of recurrence of smoking. Because susceptible environments, ease of access to cigarettes, social networks, and supporting friends of smoking, reduce the progress of smoking treatment and cessation.20
Therefore, prevention of smoking is easier than addiction treatment, and it is considered as the most appropriate and logical solution.21 Necessary requirements for the prevention of smoking include the analysis of smoking behavior among children, correcting misconceptions about smoking, empowerment of individuals against smoking since childhood, taking into account family pressures and crises of childhood and the role of social variables.22,23
Today, empowerment is one of the most important concepts in community development.24 The term empowerment was first used in texts of political and social sciences, and soon found its place in management and health issues.25 From the perspective of the WHO, empowerment as the heart of health promotion26 includes the process by which individuals gain more control over decisions and actions that affect their health.27
Empowerment has different levels, empowerment at the individual level is the elimination of personal disabilities and the formation of a sense of personal power and self-efficacy. Interpersonal competence means having the capacity and ability to influence others.28
To empower individuals, the previous studies have emphasized to improving components such as problem-solving skills, self-efficacy, self-control, self-esteem, emotional management, shifting attitudes toward smoking , and adaptation towards environmental conditions.22,29,30 In order to design appropriate prevention programs, it is necessary to be aware of the factors influencing the onset and persistence of smoking addiction. In recent years, one of the most important achievements in the field of theorizing and policy-making of prevention programs has been the emphasis on risky and protective factors as a descriptive and predictive framework.31
According to the above, this study seeks to answer the key question of what is the power of explaining the various components of empowerment related to the prevention of smoking in children and adolescents? By answering this question, we can design and implement appropriate interventions and strategies to avoid smoking behavior in adolescents and prevent and control the burden of diseases resulting from this problem.