Factors associated with tobacco use among adolescents in the Kingdom of Saudi Arabia in 2010 Open Access

Silvaggio, Jessica Lyn (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/w6634388s?locale=en
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Abstract

Background: Smoking behaviors are primarily initiated and established during adolescence. Also, among every three young smokers, only one will quit while one of the remaining two will die from tobacco-related causes. Most young people do not consider the long-term health consequences associated with tobacco use nor are they aware that nicotine is highly addictive. Little is known about these aspects of adolescent tobacco use in Saudi Arabia.

Objective: The purpose of this study is to identify specific factors associated with various types of current tobacco use including cigarette, waterpipe, and or any tobacco use among adolescents in the Kingdom of Saudi Arabia in 2010.

Methods: Using a two-stage cluster sample design, a representative sample of 13 to 15 year old school-going children was surveyed using standardized Global Youth Tobacco Survey (GYTS) questionnaires. Current smoking was defined as smoking cigarettes or waterpipe at least one day in the past 30 days. Analyses were conducted using three separate logistic regression equations for currently smoking cigarettes, waterpipe, and either. All independent variables were either dichotomous or categorical as presented in the questionnaire. We categorized exposures as they related to demographics, households, societal, access, and school-based influences.

Results: In 2010, 10.6% of adolescents were current cigarette smokers and 11.0% were current waterpipe smokers. After adjusting for the effect of other exposures in the model, the strongest predictors for cigarette and waterpipe were peer smoking, parental smoking, and household member smoking. Concerns about weight and seeing or hearing anti-smoking and anti-waterpipe media messages within the past month were protective of cigarette and waterpipe. .

Discussion: In designing interventions to prevent tobacco experimentation and use among adolescents, social context and cultural influences related to cigarette and waterpipe smoking should be considered. Other factors related to the household environment, school, and social circles of adolescents need to be considered. Using the Social Learning Theory as a foundation, school-based programs can teach students refusal skills and may have an important role in tobacco prevention in Saudi Arabia.

Table of Contents

CHAPTER 1: LITERATURE REVIEW 5

Tobacco: Defining the Problem of Cigarette and Waterpipe Smoking 6

Tobacco use in Saudi Arabia 7

The Middle East: Unique Geographical and Cultural Aspects Pertaining to Tobacco Use,

Specifically Waterpipe Smoking 8

Risk Factors Affecting Tobacco Use in Adolescents 12

Social Influences and Adolescent Tobacco Use 12

Household Influences and Adolescent Tobacco Use 14

Gender Differences in Attitudes Towards Tobacco Use 15

School-Based Influences and Adolescent Tobacco Use 16

Religion and Adolescent Tobacco Use 16

CHAPTER 2: MANUSCRIPT 18

Introduction 18

Methodology 19

Introduction: The Global Youth Tobacco Survey 19

Sample Selection 20

GYTS Questionnaire 21

Variable Definitions 22

Data Analysis 25

Results 28

Exploring factors associated with adolescent tobacco use in 2010 29

Bivariate Analysis for Current Cigarette Smokers 31

Bivariate Analysis for Current Waterpipe Smokers 31

Multivariate analysis for current cigarette smokers 34

Multivariate analysis for current waterpipe smokers 34

Multivariate analysis for any current smoker 35

Discussion 36

Study Strengths and Limitations 40

Conclusion 41

CHAPTER 3: PUBLIC HEALTH IMPLICATIONS AND POSSIBLE FUTURE DIRECTIONS 42

REFERENCES: 47

TABLES 59

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