Factors associated with smoking initiation among Saudi male adolescents: A longitudinal study
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Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht, Netherlands
Department of Clinical Sciences, College of Health and Life Sciences, Brunel University, London, United Kingdom
Mutaz Mohammed   

Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), 6200 MD Maastricht, Netherlands
Publish date: 2019-06-07
Submission date: 2019-03-18
Final revision date: 2019-05-05
Acceptance date: 2019-05-06
Tob. Prev. Cessation 2019;5(June):21
Knowing country-specific predictors of smoking behaviour for adolescents is crucial for successful smoking prevention programs. This study aims to assess demographic and socio-cognitive variables related to smoking initiation among Saudi male adolescents.

Longitudinal data were collected at T1 (baseline) and at T2 (followup at 6 months) using a self-administered questionnaire. We assessed smoking behaviour and related demographic variables and socio-cognitive variables. Chisquared tests and independent-samples t-tests were used to identify differences in baseline characteristics between smokers and non-smokers at T1. Furthermore, non-smokers at T1 were included in logistic regression analyses to examine the predictors of smoking initiation between T1 and T2.

At T1, the non-smokers who were included in further analysis were 523 (84.9%) of whom 48 (9.2%) had initiated smoking at T2. They differed significantly from non-initiators, including having a more positive attitude towards smoking, reporting more social norms, modelling and pressure to smoke, having a lower self-efficacy to refrain from smoking and higher intention to smoke in the future (all p<0.001). The regression analysis revealed that: adolescents with disrupted-families, being of low academic achievement, with relatively high monthly-income families, having more smoking-peers, high-perceived pressure to smoke from parents (p=0.002) and teachers (p=0.001), have smoking supportivenorms of parents and having high intention to smoke in the future (p<0.001) were at higher risk of being smokers.

Findings suggest that health-promoting programs should address strengthening of self-efficacy and enhancing refusal skills against modelling of peers, pressure and norms of parents.

Authors thank the masters of all participating schools. Special thanks to F. Alotaiby who helped with data collection and A. Alzahrani for arranging the school visits.
Authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
There was no source of funding for this research.
Not commissioned; externally peer reviewed.
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