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AbstractBackground: Methylation alterations of tumor suppressor gene promoters are essential aspects of epigenetic changes in gastric cancer (GC). Cadherin1 (CDH1) encodes a protein with essential roles in cell-cell adhesions. In this study association of organochlorine pesticides (OCPs) serum levels with the methylation profile of this gene was investigated in gastric cancer (GC), intestinal metaplasia (IM), and functional dyspepsia (FD) patients.Methods: GC (n=34), IM (n=8), and FD (n=48) patient serums were analyzed for the determination of OCP levels by gas chromatography equipment. The methylation status of the CDH1 gene promoter was examined by methylation-specific PCR (MSP) method. In order to confirm reduced protein expression of this gene in methylated samples, immunohistochemistry (IHC) was used.Results: Our findings revealed significant hypermethylation of CDH1 gene promoter along with reduced expression in GC patients compared with IM and FD patients. Furthermore, there was significant association between CDH1 promoter hypermethylation and 2,4-DDT (odds ratio [OR]:1.183;95%CI:1.001-1.398, p=0.048) serum levels in GC patients.Conclusion: Our results could suggest the association of 2,4-DDT OCP levels in the GC patient serums with CDH1 gene promoter hypermethylation. Additionally, this gene promoter methylation may play a role in the progression of pre-cancerous IM towards GC.

Background: Awareness, knowledge, and attitude towards waste management, environmental factors of waste disposal sites and citizens’ as well as waste generators’ behaviors should be considered for implementing a waste segregation plan at the source. Methods: The statistical population of this cross-sectional study includes 150 000 households living in Kerman. The sample size is calculated as 444 individuals using a stratified sampling method considering a 15% withdrawal probability. The correlation between Kerman citizens’ demographic data (age, gender, mean income, and household head’s educational level) and behavioral patterns (knowledge and awareness, attitude and behavior) regarding waste management and environmental factors of waste disposal sites was evaluated using SPSS software. Results: Examining the variables indicates that attitude, environmental factors, behavior, awareness, and knowledge have the highest mean and standard deviation, respectively. The highest mean score of awareness and knowledge was observed among individuals who earned 40 million IRR and higher income (2.55 ± 0.24) and those who had a PhD degree (2.63 ± 0.27). The results show that one unit increase in the score of awareness and knowledge, attitude and environmental factors could increase the mean behavior score. Conclusion: Teaching the households waste-related environmental issues and how to properly separate recyclable waste as well as providing correct information regarding the current (COVID-19 period) and future plans and policies of the waste management organization, and developing suitable motivational mechanisms could improve the performance level of a society.

Introduction Substance abuse in women has an increasing trend in all socio-economic classes. In addition to the fetal consequences, this problem has many other economic and social consequences as well.This study aimed to determine the prevalence of substance abuse and its related factors in pregnant women. Materials and MethodsThis descriptive cross-sectional study was performed employing a self-administered valid questionnaire on 587 pregnant women in Kerman, Iran who referred to public health centers and private offices to receive prenatal care. Participants were recruited from January to February 2020 using a multistage sampling method.ResultsThe most prevalent substances used during pregnancy (current use) were waterpipe (8.5%), opium (2.6%), and alcohol (1.7%).Substance abuse in first-degree relatives was a very strong correlate of substance abuse in pregnant women (OR = 7.26). The low level of education of pregnant women's husbands was also a strong predictor of substance abuse in pregnant women. (OR = 3.15).ConclusionSince substance abuse by family members was the strongest correlate of drug abuse during pregnancy, family-based interventions should be tailored to address early detection of such vulnerable women and necessary counseling services.

Background: Online education has become more vastly recognized as a powerful educational tool after the Covid-19 pandemic. It provides educational opportunities that were not previously possible because of time or place restrictions.Objectives: This study investigated the factors influencing students' acceptance of online learning systems during the Covid-19 pandemic.Methods: The study sample comprised 435 students from Kerman University of Medical Sciences. We used the external technology acceptance model (TAM) to determine the acceptance of online education systems by undergraduate students during the Covid-19 pandemic. Partial least square structural equation modeling (PLS-SEM) was used to check the model hypotheses. P-values less than 0.05 were considered statistically significant.Results: In this study, 65% of the participants were men. The mean score for the items in the questionnaire was 53.1±19.3. The constructs of perceived ease of use and perceived usefulness had a significant effect on students' attitudes, and students' attitudes and perceived usefulness strongly influenced their behavior in using the online education system.Conclusion: The results of this study show that the perceived ease of use and perceived usefulness of the online education system indirectly affect students' behavior in using online education. Thus, educational policymakers at universities can emphasize the ease of learning and especially the easy use of mobile phones when choosing an online education system. In addition, the creation and expansion of the necessary infrastructure can facilitate student use of online education.

Background: The group discussion method is one of the student-centered and active teaching methods in which learners actively participate in educational activities using discussion, and they are given the opportunity to share their opinions and experiences with others.Objectives: The present study was conducted to compare the effects of the group discussion method and the lecture method on health workers’ knowledge and attitudes.Methods: In this quasi-experimental study, 70 health workers working in Baft, Kerman province, were selected by census method and divided into two groups of 35 people. Asthma-related educational content was presented for one group as a lecture and the other as a group discussion. Before and after the intervention, health workers’ knowledge and attitudes scores were evaluated and compared using a researcher-made questionnaire.Results: The mean age of participants was 38 ± 2.7 years. After the intervention, the mean score of attitude was 65.86 ± 6 in the lecture group and 68.66 ± 4.7 in the group discussion group, indicating a significant difference (p = 0.04). The mean score of knowledge after the intervention was 11.4 ± 1.66 in the lecture group and 11.28 ± 1.6 in the group discussion group, which was not statistically significant (p = 0.77). In both groups, the mean scores of knowledge and attitude increased significantly after the intervention (p

Background: Inadequate health literacy (HL) in dialysis patients increases the risk of poor self-care and decreases severe self-care and severe negative health outcomes in these patients. This study aimed to investigate HL and its related factors in dialysis patients in Kerman, Iran, in 2021. Methods: This cross-sectional study was performed on 280 dialysis patients who referred to Kerman (Iran) dialysis centres. The participants were selected through multi-stage sampling method. The study was conducted using the Iranian Health Literacy Questionnaire (IHLQ). The higher score shows a better HL. Results: The mean age of the subjects was 57.75 ± 13.87 years. The mean score of HL was 9.12 ± 4.54 out of 20 points. During multivariate regression, there was a significant relationship between HL and age (β = -0.08, P = 0.02) and level of education (elementary/literacy (β = 4.607, P < 0.001), middle school (β = 6.38, P < 0.001), high school (β = 8.573, P < 0.001) and academic education (β = 9.410, P < 0.001), and there was a significant relationship between HL and eye disease (β = -0.903, P = 0.001). Conclusion: Most participants did not have adequate HL, while HL as the most important determinant of self-care can improve patients’ quality of life and reduce their health care costs. Therefore, in order to increase self-care, planning and necessary interventions, the HL of these patients seems to be necessary

Background: This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran.Methods: Using convenience sampling and a standard questionnaire, we recruited 104 HIV-positive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma.Results: The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=

Background: Burn wound is one of the most common injuries worldwide. However, its management still remains a health concern and research is ongoing for more efficient therapies. Persian medicine has described different methods in this regard. Previous reviews have mostly focused on the herbal-based therapies for burn management. Hence, the current study aimed to review both non-herbal and herbal-based therapies used in Persian medicine for their burn healing properties, and to compare them with new evidence.Method: The most important texts of Persian medicine were reviewed for burn wound classification, managements and treatment approaches. Moreover, herbal, minerals, and animal-based products claimed to possess burn wound healing activity, were extracted. In the next step, digital databases were searched to find new supporting data for the extracted-traditional remedies and their healing mechanisms.Results: More than one hundred traditional medicinal herbs, minerals, and animal-based products have been recommended to treat burn wound in Persian medicine among them, the healing effect of thirty-five herbs and eight non-herbal treatments (mineral and animal-based compounds) were supported by new evidence. Otherwise, there was not new evidence reporting the healing effect of seventy-three herbs and sixteen non-herbal compounds extracted from Persian Medicine literature.Conclusion: Although some managements of burn wounds in Persian medicine have been confirmed by new evidence, the efficacy of a plenty of materials needs to be methodically evaluated. Hence, it could introduce new clues for future research.

Background: The use of waterpipe tobacco smoking (WTS) is on the rise throughout the world, especiallyamong young people and even athletes. There is a belief among consumers that exercise prevents the harmfuleffects of hookah smoke on the body. We examined this belief by evaluation of lung injury following toconcurrent WTS and swimming endurance training in male Wistar rats.Methods: Animals were randomly divided to sedentary control (CTL) group, exercise training group(Ex group), sedentary WTS (S) group, and exercise plus WTS (S + Ex) group.Findings: 8 weeks of WTS was associated with significant increase in serum level of cotinine, lung damage,reduction in alveolar number AN/SA (mm2) and increase in malondialdehyde (MDA) level of lung tissue.Combination of exercise with WTS significantly decreased these negative effects; however, it could not fullyprotect the lung from smoking damage. Waterpipe smoking (WPS) also significantly increased the proinflammatory cytokines of lung tissue such as tumor necrosis factor alpha (TNF-α) (P < 0.001), interleukin 1beta (IL-1β) (P < 0.010), and IL-6 (P < 0.050) in comparison with CTL group. Exercise training to somedegree reduced the levels of pro-inflammatory cytokines and increased the level of IL-10 as an antiinflammatory IL and glutathione peroxidase (GPX) activity in animals exposed to WTS.Conclusion: It is suggested that combination of mild to moderate exercise with WTS may attenuate thehookah smoking-induced lung damage. This effect partly is mediated through balancing of pro/antiinflammatory and redox systems

Background Stigmatizing attitudes among healthcare providers are an important barrier to accessing services among people living with HIV (PLHIV). This cross-sectional study aimed to assess the status and correlates of HIV-related stigma among healthcare providers in Kerman, Iran. Methods Using a validated and pilot-tested stigma scale questionnaire, we measured HIV-related stigma among 400 healthcare providers recruited from three teaching hospitals (n = 363), private sectors (n = 28), and the only voluntary counseling and testing (VCT) center (n = 9) in Kerman city. Data were gathered using self-administered questionnaires at participants’ workplace during Fall 2016. To examine the correlates of stigmatizing attitudes, we constructed bivariable and multivariable linear regression models. Results The mean ± standard deviation (SD) of stigma score was 25.95 ± 7.20 out of the possible 50, with higher scores reflecting more stigmatizing attitudes. Paramedics, nurses’ aides, and housekeeping staff had the highest, and VCT personnel had the lowest average stigma scores, respectively. Multivariable regression analyses showed that prior experience of working with PLHIV (β = -2.48; P = .03), exposure to HIV-related educational courses (β = -2.03; P = .02), and P < .001) were associated with lower stigma scores. Conclusion Our findings highlight the need for health managers to provide training opportunities for healthcare providers, including programs that focus on improving HIV-related knowledge for healthcare providers. Enforcing policies that aim to reduce HIV-related stigma and discrimination among healthcare providers in Iran are urgently needed.

Background: Alcohol use and drug injection are prevalent among homeless youths. The aim of this study wasto identify the associated factors of alcohol consumption and drug injection among homeless youths aged18-29 years.Methods: Data on 202 homeless youths (111 males and 91 females) were collected using a standardizedquestionnaire and face-to-face interview. Lasso logistic regression was applied to determine the impact ofassociated factors on alcohol consumption and drug injection.Findings: The mean age of the participants was 26.30 ± 3.19 years. Also, the prevalence of alcoholconsumption and drug injection was 33.0% [95% confidence interval (CI): 30-36] and 4.0% (95% CI: 0-8),respectively; 6 people (3.0%) consumed alcohol and injected drugs at the same time. Correlates of alcoholconsumption and drug injection were male sex [odds ratio (OR)Alc = 5.7], age (ORAlc = 0.96 and ORDI = 0.98),bachelor or higher education level (ORAlc = 1.34), non-Iranian nationality (ORAlc = 0.05 and ORDI = 0.18),food score (ORDI = 0.92), smoking (ORAlc = 2.05), substance use (ORAlc = 1.12), opposite sex relationship(ORAlc = 1.6), homosexual relationship (ORAlc = 3.56 and ORDI = 2.69), and mental disorder (ORAlc = 0.99).Conclusion: Based on our findings, it seems that the homeless youth are more desired to use alcohol and druginjection, whereas the prevalence of alcohol consumption and drug injection in homeless youth was higherthan general youth population in Iran. Therefore, some suitable solutions are needed to prevent thehomelessness. Also, the effective variables that were identified in this study for alcohol use and drug injectioncan help design and implement beneficial interventions.

Background: Heavy vehicle drivers spend a great deal of time away from their families. This issue and other difficulties around their job may increase risky behaviors among them. The current study aims to investigate the prevalence of opium drugs, stimulants, cannabis, and alcohol use 12 hours before driving among heavy vehicle drivers. Methods: We selected two sites that were in charge of medical examination of drivers and recruited 363 drivers of heavy vehicles (trucks, trailers, and buses). We asked drivers about total number of drivers they knew and number of drivers who experienced use of different types of drugs. The data were analyzed using Network Scale Up Method (NSUM). Findings: Mean of age and job experience was 43.28 ± 10.04 years and 16.07 ± 9.67 years, respectively. The highest and lowest prevalence of drug use related to opium-based drugs at 12.8% to 14.0% and simulants at 1.97% to 2.84%, respectively. The prevalence of alcohol use 12 hours before driving was 4%. Conclusion: 12-hour before driving prevalence of opium-based drugs among drivers was high. This might put them in higher risk of road accidents. There is a need to design appropriate educational programs for them.

Background: There is an increasing popularity of waterpipe tobacco smoking (WTS) in youth and even inathletes worldwide. Despite the existence of evidence of the harmful effects of hookah smoke on varioussystems of the body, especially the cardiovascular system, its simultaneous effect with exercise training hasnot been well studied. We assessed the effects of WTS exposure with/without swimming exercise on bloodpressure (BP), and heart histology and mechanical performance in male Wistar rats.Methods: The animals were divided into 4 groups of sedentary control (CTL), waterpipe tobacco smoking (S),mild endurance swimming exercise training (Ex), and waterpipe smoking plus exercise (S + Ex). Theduration of WTS and exercise was 8 weeks.Findings: BP and heart rate (HR) did not show a significant difference among the groups. WTS increased theTNF-α level of the heart (P < 0.05 vs. CTL) and cardiac tissue lesions (P < 0.05 vs. CTL), and reduced +dP/dtmax, -dp/dt max, and heart contractility indices (P < 0.01, P < 0.01, and P < 0.05, respectively, vs. CTL andEx groups). It also increased the Tau index (P < 0.05 vs. CTL; P < 0.01 vs. Ex groups) of the left ventricle.However, the combination of exercise and WTS reduced the TNF-α level, improved the heart activity ofsuperoxide dismutase (SOD) and catalase enzymes, and prevented the negative effects of smoking on heartfunction and morphology.Conclusion: Mild exercise prevents WTS-induced left ventricular systolic and diastolic dysfunction partly viaimprovement of antioxidants and attenuation of pro-inflammatory cytokines.

In the early decades of the 20th century, discussions regarding alcohol were dominantly directed toward itstherapeutic uses, but authorities now state that any level of alcohol consumption poses negative effects onhealth. Over recent months, increased attention has been devoted to disease burdens attributable to alcoholuse worldwide. As more and more studies are conducted to illuminate the harmful effects of alcohol ondifferent body systems, the mounting evidence generated requires documentation and publication. Thecurrent review was aimed at providing an overview of the recent literature on the adverse consequences ofalcohol consumption.

Background: Social capital (SC) is one of the most important assets and a vital determinant of sustainabledevelopment of any country. The aim of this study was to determine the prevalence and the relationshipbetween SC and substance use (SU) in Southeast Iranian adolescents.Methods: This cross-sectional study was conducted among high school students in three cities located in southeast of Iran. We recruited 600 adolescents (329 girls and 271 boys) through multistage sampling duringSeptember to November 2018. The data collection instrument was a self-administered standardizedquestionnaire that included basic demographic characteristics, SC constructs items, and questions about SUbehavior in the participants.Findings: The mean SC score among boys and girls studied was 3.46 and 3.33, respectively (from 5 score).Among the SC constructs, respectively, the lowest and highest score belonged to social trust and [2.84 in girlsand 2.98 in boys with 95% confidence interval (CI) of 0.06-0.21, P < 0.001] and bonding to family (3.92 ingirls and 4.25 in boys with 95% CI of 0.22-0.44, P < 0.001). The ever use prevalence of at least one substanceabuse was 55.9% (n = 181) for boys and 36.6% (n = 68) for girls. Hookah (41.8%) and alcohol (16.9%) were themost substances abused by participants. One-point increase in score of the constructs of social participation,social cohesion, bonding with family, and bonding with schools was associated with a reduce of 17%, 22%, 26%,and 46% in the probability of ever SU, respectively.Conclusion: There was a strong relationship between SU and SC. Thus, rising SC as an effective communitybased and indirect approach can help policy makers and professionals in preventing SU in Iran. However, priorto any intervention, identification of more causality may be required

Background One of the most effective ways to prevent substance abuse is to promote addiction knowledge in influential social groups. Objectives The purpose of this study was to identify the current status of substance abuse education in medical universities of Iran in order to develop a targeted curriculum on drug abuse and include it in the curriculum of medical students. Methods In this descriptive library study, documentary (library) method and checklists were used for data collection. In order to identify the extent to which the existing units and courses deal with substance abuse and with the subject of addiction, the announced titles for active disciplines of the Ministry of Health and Medical Education were reviewed in 2017 - 2018. Results Of the 7685.5 units taught in different faculties of medical sciences universities in all disciplines except clinical residency programs.106.1% (optional or mandatory) are related to substance abuse. Of these, 49.5 units were related to the pathophysiology, treatment and pharmacology of substances, and 57.6 units covered topics related to prevention strategies and pathologies of substance abuse. Conclusions Despite the high importance of substance abuse issues for medical sciences students, a general unit for prevention and familiarity with the physical, psychological and social consequences of substance abuse does not exist in most of these disciplines. Therefore, it is recommended that studies be conducted to provide specific courses related to the substance abuse phenomenon or to consider substance abuse topics in the courses related to this subject.

Background: Opioids are amongst the most common abused drugs. Pathologic studies on opioid abuse are limited since the evaluation of inflammation and regeneration in brain tissue is not as simple as other tissues of the body. Thus, the present study aimed to determine the relationship between the dependence on morphine and inflammatory and regenerative processes. Methods: In this experimental study, 48 male wistar rats were divided into 6 groups. The dependent groups (3 groups) received 0.4 mg/ml morphine in drinking water for 7, 28, and 56 days. The control groups (3 groups) received sucrose solution in drinking water for the same period. The histopathological studies of the brain sample were done. The slides were stained by hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining method. The areas of brain were evaluated in terms of lymphocytic infiltration and glial scar. Findings: A significant difference was observed in the mean number of cells in the glial scar of the dependent group 3 (dependent for 56 days) among the control group (P = 0.040). Further, a significant relationship was reported between the increased duration of morphine use and the number of created scar glial cells. Furthermore, a significant increase in the number of astrocytes was observed in the affected areas. Conclusion: After long-term use, opioids can result in increased number of astrocytes and creating glial scar centers in the affected areas in response to the inflammation.

Background: Adolescence is the age of increased sensation-seeking and risk-taking. To prevent such behaviors, the adolescent tendency to engage in high-risk behaviors must be measureable. This study aimed to develop a questionnaire about risk-taking tendencies among Iranian students.Methods: This study was conducted using cluster sampling of the tenth-grade students in three cities in Kerman province, Iran. The students were assured that the questionnaires would remain anonymous and unlinked. Construct validity was assessed using exploratory factor analysis (EFA) and comparison of known groups. Corrected item-scale correlation and Cronbach's alpha were calculated to evaluate reliability.Findings: A total of 551 high school students participated in this study. Of these, 57 were excluded after checking the “non-existent drug” item (10.3%). Girls accounted for 49.2% of the sample. Of the 33 initial questions, 13 were removed due to factor loading of less than 0.5. Two factors were extracted using the scree plot (“drug abuse tendency" and "other risky behavior tendency"). The tendency toward high-risk behavior was significantly higher in male students than in female ones (P < 0.001). This indicates the known group validity of the questionnaire. The Cronbach's alpha of the above-mentioned factors were 0.93 and 0.83, respectively.Conclusion: The questionnaire measuring the tendency toward high-risk behavior among students showed acceptable validity and reliability.

Background: Prisoner’s addiction is one of the major problems in many countries which imposes very high medical costs and social harm to communities. This study investigated the pattern of substance use and related factors in male prisoners in one of the prisons in southeastern Iran.Methods: This cross-sectional study was carried out in 2016. The study population was inmates of a prison in southeast Iran. Sampling was carried out randomly according to the list of prisoners. Data were collected using a form and were analyzed with statistics software SPSS.Findings: More than four-fifths (75.3%) of the subjects consumed at least one substance (alcohol, tobacco and other drugs), 74.4% were smoking, 73.2% used a narcotic substance, and about one-fifth (19.3%) reported drinking alcohol. With a frequency of 62.0%, opium was the most frequently utilized narcotic substance. Poppy juice (31.6%), cannabis (29.8%), crystal (16.9%) and tramadol (16.9%) were the next frequent substances used. A percentage of 41.5% subjects reported using two or more drugs. A percentage of 80.7% subjects reported substance use among their friends, 39.2% by siblings and 37.2% by father. Regression analysis showed predictor variables of substance use were education, substance use by prisoner before being imprisoned, substance use by father, friends and siblings.Conclusion: This study showed a remarkable prevalence of substance use in prisons, which was more than general population. Therefore, it is necessary to consider alternative penalties of imprisonment due to the factors associated with substance use. Screening of people at high risk for substance use should be considered on admission to prison, and primary prevention measures should be focused on them.

Introduction: Cardiovascular diseases are the main causes of mortality and disability in the world. Many risk factors are involved in cardiovascular diseases including hypertension, high cholesterol, overweight and obesity, smoking, diabetes, inadequate physical activity, unhealthy diet. The aim of this study was to evaluate cardiovascular diseases risk factors and the relationship between knowledge level and preventive behaviors for cardiovascular diseases among women in Kerman. Methods: This descriptive-analytical cross-sectional study was performed on 400 women in Kerman. Participants were selected using multistage cluster sampling method. Data were collected using demographic questionnaire and a questionnaire about cardiovascular disease risk factors, knowledge, nutritional behavior, and physical activity. Data were analyzed using Pearson’s correlation, Spearman, one-way ANOVA, Kruskal wallis test and Mann-Whitney U test by SPSS 21. Results: The average age of women was 42.11±1.40 years. Daily stress (71.75%) and inadequate physical activity (62.75%) were the most common risk factors among the participants. There was a significant positive relationship between knowledge and nutritional behavior (P

Introduction:The first step in any educational programs is determining the educational needs of the target group. Providing adequate information to couples helps them to start their marital life based on a correct basis. The aim of this study was to determine the pre-marriage educational needs of couples who are about to get marry. Methods:This descriptive-analytical and cross-sectional study was performed on 250 couples attending in Pre-marriage counseling classes. Available sampling was used in this study. Data were collected by a questionnaire including demographic variables and 47 questions in 7 areas including family planning, congenital diseases, common cancers in men and women, sexual relationships, relationship with spouse and family, and Islamic and legal issues. Data were analyzed using analytical statistics Chi-square, t-test, ANOVA, and correlation coefficientthrough SPSS 21. Results:The results show a significant relationshipbetween the need for training and education in women and men (P

Background: Substance use is a growing public health problem among adolescents. In the lack of a valid and reliable instrument based on social development model (SDM), this study aimed to develop risk and protective factors of substance use scale based on SDM to determine risk and protective factors influencing substance use among adolescents. Methods: A total of 235 male students from 9th and 10th grade (14-18 years old) of public high schools in Kerman, Iran, selected through multistage cluster sampling. Items pool extracted from the literature and focus groups with male adolescents. Face validity of the questionnaire assessed for readability and clarity of items. Then, an expert panel evaluated the items for content validity. Consequently, construct validity of questionnaire confirmed through exploratory factor analysis (EFA). Known group validity is determined by the degree to which the instrument shows different scores between two groups of those who had an experience in drug use and those who did not have such an experience. In addition, reliability assessed via internal consistency and test-retest. Results: About 10 factor solution (containing 38 items) emerged as a result of EFA entitled adolescent’s “beliefs on hookah and alcohol,” “bonding to parents,” “family rules on substance use,” “drug resistance skills,” “adolescent’s beliefs on hard drugs,” “situational perception on hookah and alcohol,” “rules of school,” “situational perception on hard drugs,” “attachment to school,” and “perceived opportunity at school.” The first four emerged factors explained 46% of the total variance observed. Among these factors, adolescent’s beliefs on hookah and alcohol explained a more than 25.3% of the total variance. Results indicated satisfactory internal consistency (Cronbach¢s alpha ranging from 0.71 to 0.85) and intra-class correlation coefficients (ICC) (ranging from 0.48 to 0.81). Conclusion: The risk and protective factors of substance use questionnaire are the first instrument based on the SDM. The findings showed that this questionnaire is a valid and reliable instrument for assessing determinants of substance use which can be used by researchers and policymakers in preventive initiatives.