Towards a better understanding of factors affecting smoking uptake among Saudi male adolescents: A qualitative study
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Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
Mutaz Mohammed   

Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, 6200, MD, The Netherlands
Publication date: 2020-05-15
Submission date: 2020-02-25
Final revision date: 2020-03-29
Acceptance date: 2020-04-01
Tob. Prev. Cessation 2020;6(May):29
An increased smoking uptake by Saudi male adolescents and a lack of data about its determinants emphasize the need for a better understanding of factors leading to the onset of smoking and identifying ways to prevent it. The aim of this qualitative study is to explore adolescents’ views on smoking and their opinions about a smoking prevention program.

A total of 103 school-going adolescents, aged 12–16 years, were purposely selected from grades seven, eight and nine from nine schools in Taif in Saudi Arabia. They were interviewed in 11 focus group discussions; five groups were held for smokers and six for non-smokers. An interview scheme was developed based on the I-Change Model, a model used for understanding smoking onset and prevention. We used QDA Lite version 2:0 software for data analysis.

Most of the participants agreed on the importance of social influences as determining factors to start smoking. The presence of smoking friend(s) and family member(s), especially the father, were mentioned. Factors such as having extra pocket money, absence of alternatives, showing off, to be seen as western, to be seen as an adult and the good taste of cigarettes were also mentioned as beliefs associated with smoking. Adolescents indicated to have low confidence not to smoke under peer pressure, suggesting self-efficacy problems. Intentions to smoke were also often mentioned. Almost all participants agreed that an interactive approach is optimal for an effective smoking prevention program.

Determinants of smoking seem to be very similar to those outlined by previous studies. A smoking prevention program for Saudi adolescents should address how to cope with social pressure to smoke, the advantages connected with smoking, and how to increase self-efficacy. Information should be presented in an interactive rather than static way.

We would like to thank the participating schools, the schools’ principals and the participating students. Special thanks for Fahad Alotaibi who was in charge of the audio-visual recording and Ahmed Alzahrany who arranged the school visits.
The 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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