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To the best of our knowledge, no study has investigated the factors associated with smoking intensity in the Iranian adult population while accounting for zero-inflation and overdispersion in this count response variable

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From local Health and Wellbeing Surveys, the percentage who had never smoked was relatively consistent over time (42.6% in 2007, 44.4% in 2009, 39.7% in 2011 and 42.3% in 2014 although this was slightly higher in 2019 at 46.6%)