Background The present study aimed to investigate the effects of a multi-level intervention on hookah smoking frequency and duration among Iranian adolescents and adults. Methods In this study, two comparable cities in Iran were selected to participate in an intervention program based on a social-ecological model (SEM). In each city, 133 hookah smokers in coffee houses were selected. Environmental changes in coffee houses such as serving light foods and games were conducted. A virtual group named “no hookah” was established on the Telegram application to train participants in the intervention group. Messages, pictures, and short videos were sent to the participants through that virtual network. The frequency and duration of hookah consumption were assessed in both groups at baseline and after the intervention. Results The frequency of hookah consumption decreased in 72.6% of participants in the intervention group (vs. 6.3% in the control group), and the duration of hookah consumption per session decreased in 39.5% of participants in the intervention group (vs. 5.5% in the control group). Conclusions Using multi-level interventions through a social-ecological model can reduce hookah consumption in adults.

Background: Tobacco smoking is the second leading cause of death and is closely linked to fatal diseases. Hookah Smoking (HS) is a traditional way to smoke tobacco, especially in the Eastern Mediterranean region that is constantly rising around the world. This study aimed to evaluate the different levels of personal, interpersonal and social HS in Iranian urban men and determine the most important predictors of the levels through applying the socio-ecological approach (SEA). Methods: This study was conducted in the coffee houses of Hashtrud and Qarah Aghaj counties in East Azerbaijan, Iran. Data collection was conducted from the entire coffee house (n = 18) from April to June 2017. Systematic sampling was employed to recruit 266 men in the coffee house. A valid and reliable instrument was used to investigate the frequency of HS and its determinants based on SEA. The SEA consists of three levels: personal (age, education, employment, income, and perceived severity and sensitivity), interpersonal (perceived reward), and social level (social support) intended to assess HS determinants. Hierarchical regression was used to determine the predictive value of SEA levels and frequency of HS. Results: The mean age of daily hookah smokers (once per day and more than once per day) were (26.8) significantly lower than those (30.4) smokes weekly (once a week or more than once a week). The hierarchical logistic regression model showed that in the first step individual variables significantly predict 25.1% HS. In the second and third level interpersonal and social levels of SEA explained HS 30.1 and 30.8%, respectively. Conclusion: This study found that age, income, education, and perceived reward were all important factors influencing HS among men youth. Application of SEA to determine the factors associated with HS could contribute in the development of a holistic prevention program.

Background: Tuberculosis has been recognized as a risk to health care workers for several decades. Nevertheless, little information is available about the situation of tuberculosis infection in health care workers in Iran. The aim of this study was to ascertain the prevalence of latent tuberculosis infection and pulmonary tuberculosis, and to assess the risk factors for tuberculosis infection among health care workers in Hamedan, Iran.Methods: Tuberculin skin test was conducted among 245 health care workers in two educational hospitals in Hamedan. The reaction was reported as ''positive'' if the diameter of induration was equel to or more than 10mm. Individuals with a positive test more than 15 mm were encouraged to seek further medical evaluation, including a chest-x-ray, and smear and culture of the sputum for acidfast bacilli in those with radiographic changes indicating tuberculosis.Results: Out of 245 health-care workers included in this study, 92 (38%) had positive tuberculin test. There was a significant association between the increase of age and tuberculin positivity. In addition, there was a significant association between the length of employment and tuberculin positivity. Ward attendants had higher rates of positive test than the other occupational groups. Fifty-six subjects showed tuberculin reaction of more than 15 mm, 4(7.1%) of them had calcification on radiograph. No cases of active pulmonary tuberculosis were found in the subjects.Conclusion: Latent tuberculosis infection is common among health-care workers. Age, occupational group, and length of employment are strongly associated with risk of tuberculin positivity. More emphasis on tuberculosis control measures and regular staff screening may be needed.

Background The aim of the present study was to investigate the effects of a multi-level intervention based on the social ecological model on the frequency and duration of hookah smoking among a sample of Iranian adults. Methods In this study, two comparable cities in Iran were selected to participate in an intervention program based on a social ecological model (SEM). In each city, 133 hookah smokers in coffee houses were selected. Environmental changes in coffee houses such as serving light foods and games were conducted. A virtual group named "no hookah" was established on the Telegram application to train participants in the intervention group. Messages, pictures and short videos were sent to the participants through that virtual network. The frequency and duration of hookah consumption were assessed in both groups at baseline and after the intervention. Results The frequency of hookah consumption decreased in 72.6% of participants in the intervention group (vs. 6.3% in the control group); and the duration of hookah consumption per session decreased in 39.5% of participants in the intervention group (vs. 5.5% in the control group). Conclusions Using multi-level interventions through a social ecological model can reduce hookah consumption in young people.