Abstract
BACKGROUND: Smoking remains a serious public health issue on a global scale and warrants increased attention. This research aimed to assess the prevalence of smoking and identify key predictors driving the adoption of smoking prevention behaviors among university students in northern Iraq. Study Design: A cross-sectional study. METHODS: An online study was conducted among 765 students at Raparin University, Sulaymaniyah, Iraq. The required data were collected using a structured questionnaire distributed through Google Forms. The questionnaire, developed from standardized instruments, assessed sociodemographic factors and determinants of smoking behaviors. Finally, the data were analyzed by SPSS-16 using linear and logistic regressions. RESULTS: The average age of the students was 21.04 years [95% confidence interval: 20.89, 21.20], with ages ranging from 17 to 29 years. The age group of 21-23 years old increased the chances of cigarette smoking among students (odds ratio [OR]: 2.068). In addition, male students were more likely to have cigarette smoking (OR: 11.675). Father smoking, brother smoking, and friend smoking increased the chances of cigarette smoking by 1.981, 2.687, and 10.426 times among students, respectively. Our study identified key determinants of smoking preventive behaviors, including peer pressure (B=0.507), self-image (B=0.235), belief (B=0.134), value (B=0.184), attitude (B=0.115), and the influence of friends who smoke (B=-1.110). CONCLUSION: Our findings emphasize the critical roles of peer pressure and self-image in influencing smoking behaviors among students. To address this issue, targeted educational programs that foster positive self-image and resilience against peer influence are vital for effective smoking prevention strategies.