title: Prevalence and Determinants of Waterpipe Tobacco Use among Adolescents in Oman.
abstract: OBJECTIVE
  To assess the prevalence and determinants of waterpipe use among school-going adolescents in Oman.
  
  
  METHODS
  A cross-sectional, school-based study was conducted in 2003 involving 9 regions of Oman, as part of the Global Youth Tobacco Survey. Participants were requested to complete an anonymous questionnaire containing demographic characteristics, current and previous use of waterpipe tobacco, attitudes towards cigarette smoking, parents' and friends' cigarette smoking habits. Proportions were used to calculate prevalence rates and logistic regression analysis to obtain odds ratio (OR) and 95% confidence interval (CI).
  
  
  RESULTS
  1,962 students participated of whom 1,005 (51.2%) were males. Eighty-eight percent were between 13 and 16 years of age. Five hundred and twenty-two (26.6%) reported ever smoking waterpipe tobacco while 189 (9.6%) were current users. Among males, 155 (15.5%) were current users while among females only 24 (2.6%) smoked currently. Study participants were more likely to use waterpipe if they had a parent or friend who smoked cigarettes. Adolescents were, however, less likely to use waterpipe tobacco if they believed that cigarette smoking was harmful to health. Students who were receiving 500 Baisas (US$ 1.3) or more per day pocket money were more likely to use waterpipe tobacco compared to those receiving less (OR 3.3, 95% CI 2.3 to 4.6). In multivariate analysis, the OR for males being a smoker of waterpipe tobacco compared to females was 4.46 (95% CI, 2.38 to 8.35); while the OR for most or all friends smoking cigarettes compared to non-smoking was OR 5.65 (95% CI 2.87 to 11.13). Study participants who perceived smoking as harmful to health were less likely to use waterpipe tobacco compared to those who did not believe smoking was harmful (OR 0.31, 95% CI 0.29 to 0.92) and those receiving 500 Baisas or more (OR 2.2, 95% CI 1.5 to 3.2).
  
  
  CONCLUSIONS
  Waterpipe smoking among Omani adolescents is an emerging public health concern. Efforts to prevent adolescent smoking should be designed with knowledge of associated factors of such behaviour and should include all forms of tobacco.
authors.affiliation: Department of Non-Communicable Diseases, Ministry of Health, Muscat, Oman;
authors.forename: Jawad A
authors.initials: JA
authors.lastname: Al-Lawati
authors.forename: Adamson S
authors.initials: AS
authors.lastname: Muula
authors.forename: Sahar A
authors.initials: SA
authors.lastname: Hilmi
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Rudatsikira