The present study aimed to estimate the prevalence of smoking status and its associated factors in Iranian adolescents and a meta-analysis of recent cross-sectional studies in order to estimate the corresponding prevalence for all Iranian adolescents. In a cross-sectional study, 1064 male high school students in Zanjan city (northwest of Iran) were recruited. A self-administered questionnaire was used for smoking status and associated factors. Through the meta-analysis, all relevant published studies were reviewed. Almost one-third of adolescents (34.2%, n=354) have experienced smoking either experimentally (23.4%, n=242), or regularly (10.8%, n=112). Multivariate analysis showed that older age (OR=1.20; 95% CI: 1.05-1.37), risky behaviors (OR=1.83; 1.25-2.68), Tramadol medication (OR=2.19; 1.54-3.11), low self-esteem (OR=1.07; 1.03-1.11), positive attitude toward smoking (OR=1.15; 1.09-1.21), positive thinking about smoking (OR=1.07; 1.01-1.14) and having smoker friends (OR=1.94; 1.36-2.77) were significantly associated with cigarette smoking in adolescents. Meta-analysis results showed that 7% of Iranian adolescents are regular smokers and 27% are experimenters. Increasing prevalence of smoking in Iranian adolescents is a major concern for public health. Controlling risky behaviors and increasing health education are recommended.
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