Estimation of The Prevalence of Cigarette, Hookah, and Alcohol Consumption in Iran: Network Scale-up Method

Background: Risky behaviors such as smoking, alcohol consumption, and substance use are increasingly observed among Iranian youth. These behaviors pose serious health and social risks. Understanding their prevalence is crucial for effective prevention and intervention strategies. Objectives: This study aimed to estimate the prevalence of cigarette, hookah, and alcohol consumption among individuals aged 18 - 40 years in Shahrekord, Iran, using the indirect network scale-up method (NSUM). Methods: A cross-sectional analytical study was conducted in 2023 on 700 individuals (350 males and 350 females) aged 18 - 40 years, selected via two-stage random sampling from the SIB system of Shahrekord Health Center. The NSUM was used to estimate high-risk behaviors, and social network size was estimated using both ratio and regression-based approaches. Results: The participants were 700, including 350 (50%) men and 350 (50%) women, with an age range of 18 - 40 years and a mean and standard deviation of 30.14 ± 6.32. The social network size was estimated to be 117 (111.39 - 123.99). Using NSUM, the estimated prevalence (95% CI) of hookah, cigarette, and alcohol consumption among the target population was 22% (21.67 - 22.35), 18.87% (18.56 - 20.20), and 9.52% (9.28 - 9.76), respectively. Conclusions: Findings indicate that the active social network size of individuals aged 18 - 40 in Shahrekord is somewhat lower than the national average. Moreover, the prevalence of hookah, cigarette, and alcohol use is notably high, underscoring the need for targeted health interventions to prevent substance abuse in this age group.