Gender-based Differences in Associations between Attitude and Self-esteem with Smoking Behavior among Adolescents: A Secondary Analysis Applying Bayesian Nonparametric Functional Latent Variable Model

Background: Different patterns of gender-based relationships between attitude toward smoking and self-esteem with smoking behavior have reported. However, such associations may be much more complex than a simply supposed linear relationship. We aimed to propose a method of providing hand details on the total and gender-based scenarios of the relationships between attitude toward smoking and self-esteem with smoking. Materials and Methods: A secondary analysis conducted on a data set obtained for a cross-sectional study among 4,905 male and female high school students in Tabriz, Iran (2012). We randomly selected 196 classes in a clustering process and invited all the students in the classes to participate in the study; then, investigated the relationship between smoking with attitude and self-esteem, as explanatory variables. We also found the data to fit a nonlinear functional relationship and to be free from normal condition due to applying Bayesian nonparametric functional latent variable model. Results: Among all the students, attitude was found as the only variable with conceptual effect on smoking (p<0.05). Among boys, self-esteem showed no conceptual effect on smoking which was in contrast to those found among girls. Smoking among male students with low self-esteem was high, but it was gradually decreasing by rising self-esteem. Among girls, in contrast, smoking was descending by decreasing self-esteem. Conclusion: The relationships between self-esteem and attitude with smoking may not be necessarily linear. Being at the high levels of self-esteem among boys may lead to the reduced levels of smoking, and among girls may result in the increased level of the behavior.