Effects of a multi-level intervention on hookah smoking frequency and duration among Iranian adolescents and adults: an application of socio-ecological model

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