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Risk Factors for Smoking among Secondary School Students, Riyadh, Saudi Arabia, 1997.


Saudi Arabia has always placed strong limitations on the commercial promotion of tobacco products. Nevertheless, young Saudis continue to take up the tobacco habit. In 1997 we conducted a cross-sectional survey of smoking behavior among male secondary school students in Riyadh the capital city of Saudi Arabia to determine the prevalence of tobacco smoking and possible influences acting on adolescents to begin smoking.


A probability sample of 886 male secondary school students in Riyadh city was selected. An anonymous self-completed questionnaire was administered concerning the students smoking behaviors and their families. We computed the prevalence of smoking and prevalence ratios for potential influences on smoking after adjusting for age and weighting responses for the survey design. Analysis was performed using the CSAMPLE survey analysis module of EPIINFO 6.04a.


Among Riyadh secondary school students (mean age 15.5 years) the prevalence rate of smoking tobacco products was 25% (95% confidence interval [CI] = 20%-31%). Prevalence of smoking increased with age from 10% (95% CI = 7.2%-14%) among 15 to 16 year-old students to 41% (95% CI = 34% to 48%) among students over 18 years old. 55% (95% CI = 48%-62%) had tried smoking rising from 39% (95% CI = 30%-47%) among students over 18 years old. Among students who smoked 67% (95% CI 61%-73%) had first tried smoking before they were 13 years old. The prevalence of smoking increased with the number of smokers at home from 16% with no smokers at home to 79% with 4 or more smokers at home (prevalence ratio [PR] = 4.0, 95% CI 1.3-12). Students with higher weekly allowances also had a higher prevalence of smoking (PR = 1.7, 95% CI = 1.1-2.5). Having a teacher who smoked was also associated with smoking (PR = 1.8, 95% CI = 1.6-2.0). The two most common reasons cited for starting to smoke were to be like their friends (24%) and as a reaction to family problems (22%).


In Riyadh Saudi Arabia, the home and school environments are strong influences on smoking behavior of secondary school students.