Prevalence of Smoking Among Iranian University Students: A Systematic Review and Meta-Analysis Publisher Pubmed



Sadeghi F¹ ; Alizadeh A¹ ; Hosseinzadeh F¹ ; Negarandeh R² Show Affiliations
Source: BMC Public Health Published:2025

Abstract

Background: The tobacco epidemic is one of the biggest threats to public health globally. This study evaluates the prevalence of smoking among Iranian university students. Methods: A comprehensive search was conducted in international databases (Web of Science, Scopus, PubMed) and domestic databases (Magiran, SID, Irandoc). Cross-sectional studies in Farsi and English from 2012 to 2023 were included. The Newcastle–Ottawa scale was used to assess the quality of the articles. Heterogeneity was examined using Cochran’s test and the I2 index. Due to high heterogeneity, a random effects model was employed to estimate smoking prevalence, and a funnel plot was used to assess publication bias. Results: Out of 840 articles identified through the search, 149 records were removed as duplicates. Of the remaining 691 records screened for relevancy to the review question, 635 were excluded. Fifty-six reports were sought for full-text retrieval, and 54 full-text articles were successfully retrieved. However, 11 reports were excluded due to invalid data or insufficient information. Ultimately, 43 studies reporting the prevalence of smoking or the number of smokers in general, by gender, were included in the analysis. Specifically, 28 studies were included for males, 23 for females, and 43 for overall conditions. The overall prevalence of smoking was estimated to be 16% for both sexes combined, 26% for males, and 7% for females. Conclusions: The prevalence of smoking among male and female students is high. Due to the high heterogeneity of the studies, the results of this meta-analysis should be interpreted with caution. Trial registration: The study is registered in Prospero with the code CRD42021240264. © The Author(s) 2025.