title: Smoking uptake among Saudi adolescents: tobacco epidemic indicators and preventive actions needed.
abstract: The aim of this cross-sectional school-based study was to assess smoking prevalence, indicators for the smoking epidemic and determinants of smoking among Saudi adolescents. The study included 695 male adolescents from 11 to 16 years of age who filled out self-report questionnaires based on the European Smoking Framework Approach questionnaire, which uses the I-Change model to assess attitude, social influence and the self-efficacy of the participants. Smokers were 275 (39.6%) adolescents. Smokers tended to receive more daily pocket money, live in more affluent families and show lower academic performance. Non-smokers were inclined to believe that smoking may help people to feel relaxed and confident, encountered less social influences to smoke than smokers, but reported low self-efficacy not to smoke when with smoker friends and when offered a cigarette. Smokers reported the lowest self-efficacy not to smoke in all situations assessed. The results suggest the smoking epidemic among male Saudi adolescents may still be in the early stages, providing ample opportunity for preventive actions aimed at halting the further progress of this epidemic. Secondly, smoking prevention programs in Saudi Arabia need to reinforce non-smoking attitudes, address how to resist pressure to smoke, and how to develop high self-efficacy towards non-smoking in various situations.
authors.affiliation: 1. Maastricht University - School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands.
authors.forename: Mutaz
authors.initials: M
authors.lastname: Mohammed
authors.affiliation: 1. Maastricht University - School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands.
authors.forename: Sander Matthijs
authors.initials: SM
authors.lastname: Eggers
authors.affiliation: 2. School Health Program, Dawadmy School Health Unit, Saudi Arabia.
authors.forename: Fahad Falah
authors.initials: FF
authors.lastname: Alotaiby
authors.affiliation: 1. Maastricht University - School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands.
authors.forename: Nanne
authors.initials: N
authors.lastname: de Vries
authors.affiliation: 1. Maastricht University - School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D012424:Rural Population; D012529:Saudi Arabia / Q000453:epidemiology; D020377:Self Efficacy; D057566:Self Report; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D000074606:Smoking Prevention / Q000379:methods; D012959:Socioeconomic Factors; D014505:Urban Population
keywords: I-change model; Saudi Arabia; adolescents; motivational determinants; smoking epidemic