Addiction is one of the main problems in all countries of the world (
1,
2). In Iran, deaths related to drug abuse are considered as the second cause of abnormal death after traffic accidents (
3,
4). Statistics of Iran drug control headquarters show that in 2012, 2.65 percent of people in the 15 - 64 year old age group use drugs. It also estimated the approximate number of addicts to be 1.325 million in Iran (
4,
5). Addiction among the youth has experienced an increasing trend. According to the Census 2005, 61.22 percent of addicts were between 20 and 29 years old (
5). Alarmingly in the last two decades, the age of addicts and drug users has dropped below the age of 20 and in some cases even to 8 years old (
6). This threatens social cohesion, affects economic activities and human capital formation and negatively affects the health care system.
Addiction has many negative consequences including the disintegration of families, loss of financial resources, and other social deviations such as theft, murder, etc. The undesirable effects of this damaging social problem not only involve the addict, but also all those who are associated with the addicted person (
7). Besides the physical adverse consequences of addiction including malnutrition, hypertension, and cancer, addicted individuals will be exposed to dangerous diseases such as AIDS and hepatitis. Research has shown that addicts suffer from lower psychological well-being because they often experience anxiety, irritability, depression, psychosis, loss of control, and lack of confidence (
8). The addicted person also negatively affects the people around them, especially their immediate family members.
Easy access to drugs and the environment are two of the major reasons that spread addiction among the youth (
6). It is common to find students affected by addiction. The community and family members hardly suspect that addiction could occur among students, since in their mind, students are supposed to be in school and engaged in learning with little or no opportunity for distraction to drugs (
9).
Generally, factors that affect addiction potential in the youth are grouped into internal and external factors. Family (poor parent-child relationships), peer pressure (friends who are addicted), socio-economic condition (unemployment, growing urbanization, and geographical proximity to drug producing areas), community policies, feeling of loneliness as well as isolation are the main external factors that cause potential addiction (
10). Internal factors that influence addiction include genetics, depression, stress, self-concept, self-esteem, mental health and personality traits, the lack of attention to religious affiliation, and not being powerful enough to say “no” to the demands of others had the greatest role in the addiction potential (
11). Rezaei et al (2014) reported that the presence of an addicted person in the family is a factor for addiction potential (
7). Moreover, the results of different studies suggested some factors such as gender (
10), family relationships (
12), poverty (
13), and religious beliefs (
14) in tendency to addiction.
Among the internal factors, personality traits are lesser-known factors while they play an important role in the formation of addiction and are regarded as strong predictors (
10). Personality traits consist of neuroticism, extroversion, openness to experience, agreeableness as well as conscientiousness (
15). Hardiness is another personality trait proposed by Kobasa et al. (1979) that could explaine resistance to addiction (
16). They believe that hardiness acts as a source of resistance to encounter stressful life events. This personality trait has three components: commitment, control, and challenge. An individual who has high commitment believes in the importance and value of his/her existence and action. Similarly, an individual with the proper control has faith in his/her ability. Thus, the level of control in a person indicates his/her ability to accept life changes as normal life features and path. Being able to take challenges (whether positive or negative) is considered as an opportunity for personal growth which contributes to hardiness (
17). Moreover, individuals who are high in hardiness often possess certain characteristics such as high intelligence, lack of substance abuse and delinquency, independency, empathy, commitment to work, and have good relationships with peers (
18). In short, hardiness makes a defense mechanism to addiction since individuals who score high on hardiness are less susceptible to addiction.
Whilst it is important to understand barriers to addiction, it is equally important to identify factors that contribute to addiction potential. Some of the common contributing factors for addiction among the younger population as explained earlier are geographical proximity to locations of drug producing regions and hence the convenient access to drugs. Some studies have also pointed out the importance of the relationship between addiction and the psychosocial, cultural, and genetic factors that affect tendency towards addiction (
19,
20). Up to now, no research has been directly conducted to examine the relationship between addiction and hardiness, an important personality trait to predict addiction potential among university students (
21,
22).
The main purpose of this study is to examine the relationship between hardiness and addiction potential among Iranian university students. This group of people is different from their peers in terms of their position, thinking ability as well as social respect in the present and the future. This ability and prestige deter them from addiction (
10). We hypothesize a negative relationship between hardiness and tendency to addiction, and hence the higher the hardiness score, the lower the addiction potential in a sample of medical students. The second objective of this research is to determine if socio-demographic factors (i.e. age, sex, marital status, economic status, education level, religious beliefs, living arrangement, and type of family relationship) are predictors of hardiness and addiction potential among medical students.