Skip to main content
Log in

Psychosocial predictors of smoking among secondary school students in Al-Hassa, Saudi Arabia

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

The objective of this study was to determine the prevalence and determinants of the current smoking status among secondary school students in Al-Hassa, Saudi Arabia. A total of 1,652 secondary school adolescents were selected by multistage proportionate sampling method. Data collection was carried out through self-administered anonymous questionnaire including: Arabic version of the Global Youth Tobacco Survey, modified Fagerstrom Test for Nicotine Dependence and Patient Health Questionnaire to asses for anxiety and depressive disorders. This study revealed that the prevalence of current smokers was 21.7. Seventy-one percent of current cigarette smokers were minimally nicotine dependent. Major depressive and anxiety disorders were significantly higher among current smokers. Hierarchical regression analysis shows that, male, older age, smoking of close relatives and friends, anxiety disorders and socializing motives were statistically significant determinants of current smoking status among the included adolescents. Family members should be made aware of the detrimental influence their smoking behavior has on their youth. Counseling and preventive psychiatric services should be an integral part of the clinical facilities caring for secondary school students.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abdalla, A. M., Al-Kaabba, A. F., Saeed, A. A., Abdulrahman, B. M., & Raat, H. (2007). Gender differences in smoking behavior among adolescents in Saudi Arabia. Saudi Medical Journal, 28(7), 1102–1108.

    PubMed  Google Scholar 

  • Abdalla, A. M., Saeed, A. A., Abdulrahman, B. M., Al-Kaabba, A. F., & Raat, H. (2009). Correlates of ever-smoking habit among adolescents in Tabuk, Saudi Arabia. Eastern Mediterranean Health Journal, 15(4), 983–992.

    PubMed  CAS  Google Scholar 

  • Abolfotouh, M. A., Abdel Aziz, M., Badawi, I. A., & Alakija, W. (1998). Smoking intervention program for male secondary-school students in Saudi Arabia. Eastern Mediterranean Health Journal, 3, 90–100.

    Google Scholar 

  • Abou-Zeid, A. H., Hifnawy, T. M., & Abdel Fattah, M. (2009). Health habits and behaviour of adolescent schoolchildren, Taif, Saudi Arabia. Eastern Mediterranean Health Journal, 15(6), 1525–1534.

    PubMed  CAS  Google Scholar 

  • Al Yousef, M. A., & Karim, A. (2001). Prevalence of smoking among high school students. Saudi Medical Journal, 22(10), 8723–8724.

    Google Scholar 

  • Al-Damegh, S. A., Saleh, M. A., Al-Alfi, M. A., & Al-Hoqail, I. A. (2004). Cigarette smoking behavior among male secondary school students in the Central region of Saudi Arabia. Saudi Medical Journal, 25(2), 215–219.

    PubMed  Google Scholar 

  • Al-Faris, E. A. (1995). Smoking habits of secondary school boys in rural Riyadh. Public Health, 109(1), 47–55.

    Article  PubMed  CAS  Google Scholar 

  • Al-Gelban, K. S. (2007). Depression, anxiety and stress among Saudi adolescent school boys. The Journal of the Royal Society for the Promotion of Health, 127(1), 33–37.

    Article  PubMed  Google Scholar 

  • Al-Haddad, N., & Hamadeh, R. R. (2003). Smoking among secondary-school boys in Bahrain: Prevalence and risk factors. Eastern Mediterranean Health journal, 9(1–2), 78–86.

    PubMed  CAS  Google Scholar 

  • Al-Mohamed, H. I., & Amin, T. T. (2010). Pattern and prevalence of smoking among students at King Faisal University, Al Hassa, Saudi Arabia. Eastern Mediterranean Health Journal, 16(1), 56–64.

    PubMed  CAS  Google Scholar 

  • Al-Sabie, A. (1989). Psychiatry in Saudi Arabia: Cultural perspectives. Trans-Cultural Psychiatric Research Review, 26, 245–262.

    Article  Google Scholar 

  • Al-Turki, Y. A. (2006). Smoking habits among medical students in Central Saudi Arabia. Saudi Medical Journal, 27(5), 700–703.

    PubMed  Google Scholar 

  • Al-Turki, Y. A., & Al-Rowais, N. A. (2008). Prevalence of smoking among female medical students in the College of Medicine, Riyadh, Saudi Arabia. Saudi Medical Journal, 29(2), 311–312.

    PubMed  Google Scholar 

  • Bassiony, M. M. (2009). Smoking in Saudi Arabia. Saudi Medical Journal, 11(7), 876–881.

    Google Scholar 

  • Bilir, N., Dogan, B. G., & Yildis, A. N. (1997). Smoking behavior, publication no. 7. Ankara: Hacettepe Public Health Foundation (in Turkish).

  • Breslau, N., & Klein, D. F. (1999). Smoking and panic attacks. Archive General Psychiatry, 56, 1141–1147.

    Article  CAS  Google Scholar 

  • DeCoster, J. (2006). Applied linear regression notes set 1. http://www.stathelp.com/notes.htm.

  • Dewairy, M. (1999). Toward psycho-cultural approach in Middle Eastern societies. Clinical Psychology Review, 19(8), 909–915.

    Article  Google Scholar 

  • Dierker, L. C., Avenevoli, S., Merikangas, K. R., Flaherty, B. P., & Stolar, M. (2001). Association between psychiatric disorders and the progression of tobacco use behaviors. Journal American Academic Child Adolescent Psychiatry., 40(10), 1159–1167.

    Article  CAS  Google Scholar 

  • Diez-Quevedo, C., Rangil, T., Sanchez-Planell, L., Kroenke, K., & Spitzer, R. L. (2001). Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosomatic Medicine, 63(4), 679–686.

    PubMed  CAS  Google Scholar 

  • Fagerström, K. O., & Schneider, N. G. (1989). Measuring nicotine dependence: A review of the Fagerström tolerance questionnaire. Journal Behavioral Medicine, 12, 159–182.

    Article  Google Scholar 

  • Felimban, F. M., & Jarallah, J. S. (1994). Smoking habits of secondary school boys in. Riyadh, Saudi Arabia. Saudi Medical Journal, 15(6), 438–442.

    Google Scholar 

  • Ferreira, M. M., & Torgal, M. C. (2010). Tobacco and alcohol consumption among adolescents. Review Latin America Enfermagem, 18(2), 255–261.

    Article  Google Scholar 

  • Friedman, L. S., Lichtenstein, E., & Biglan, A. (1985). Smoking onset among teens: An empirical analysis of initial situations. Addictive Behavior, 10(1), 1–13.

    Article  CAS  Google Scholar 

  • Gilpin, E. A., & Pierce, J. P. (2001). Smoking initiation. Pulmonary and critical care online update. Last Accessed October 4, 2009, from http://www.chestnet.org/education/pccu/vol12/lesson05.html.

  • Goddard, E. (1990). Why children start smoking? Office of population census and surveys (social survey division). London: HMSO.

  • Golan, L., Lubanda, J. C., Netuka, M., Bosanska, L., Lubanda, H., Linhart, A., et al. (2004). Tobacco use amongst high school students in the Czech Republic. Central European Journal Public Health, 12(1), 32–35.

    CAS  Google Scholar 

  • Griesler, P. C., Hu, M. C., Schaffran, C., & Kandel, D. B. (2008). Comorbidity of psychiatric disorders and nicotine dependence among adolescents: Findings from a prospective, longitudinal study. Journal American Academy Child Adolescent Psychiatry, 47(11), 1340–1350.

    Article  Google Scholar 

  • GYTS: Core Questionnaire. (2001). Centers for disease control and prevention. Accessed June 15, 2010, from http://www.cdc.gov/tobacco/global/GYTS/questionnaire.htm.

  • Hassan, H. (2003). The economics of tobacco in Egypt: A new analysis of demand. World Bank Publications. Last Accessed January 15, 2010, from http://www.emro.who.int/tfi/TobaccoEconomics-Egypt.pdf.

  • Henkel, V., Mergl, R., Kohnen, R., Allgaier, A. K., Möller, H. J., & Hegerl, U. (2004). Use of brief depression screening tools in primary care: Consideration of heterogeneity in performance in different patient groups. General Hospital Psychiatry, 26(3), 190.

    Article  PubMed  Google Scholar 

  • Jarallah, J. S., al-Rubeaan, K. A., al-Nuaim, A. R., Al-Ruhaily, A. A., & Kalantan, K. A. (1999). Prevalence and determinants of smoking in three regions of Saudi Arabia. Tobacco Control, 8(1), 53–56.

    Article  PubMed  CAS  Google Scholar 

  • Jarallah, J. S., Bamgboye, E. A., al-Ansary, L. A., & Kalantan, K. A. (1996). Predictors of smoking among male junior secondary school students in Riyadh, Saudi Arabia. Tobacco Control, 5(1), 26–29.

    Article  PubMed  CAS  Google Scholar 

  • Jha, P., & Chaloupka, F. J. (Eds.). (2000). Tobacco control in developing countries. Oxford: Oxford United Press for the World Bank and WHO.

    Google Scholar 

  • Kandel, D. B., Hu, M. C., Griesler, P. C., & Schaffran, C. (2007). On the development of nicotine dependence in adolescence. Drug Alcohol Dependence, 91(1), 26–39.

    Article  CAS  Google Scholar 

  • Kandela, P. (2000). Narghile smoking keeps Arabs in wonderland. Lancet, 356(9236), 1175.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Berglund, P., Borges, G., Nock, M., & Wang, P. S. (2005). Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. JAMA, 293(20), 2487–2495.

    Article  PubMed  CAS  Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal General Internal Medicine, 16(9), 606–613.

    Article  CAS  Google Scholar 

  • Kwamanga, D., Odhiambo, J., & Amukoye, E. (2003). Prevalence and risk factors of smoking among secondary school students in Nairobi. East African Medical Journal, 80(4), 207–212.

    PubMed  CAS  Google Scholar 

  • Maziak, W., & Mzayek, F. (2000). Characterization of the smoking habit among high school students in Syria. European Journal Epidemiology, 16(12), 1169–1176.

    Article  CAS  Google Scholar 

  • Maziak, W., Rastam, S., Eissenberg, T., et al. (2004). Gender and smoking status based analysis of views regarding waterpipe and cigarette smoking in Aleppo, Syria. Preventive Medicine, 38, 479–484.

    Article  PubMed  CAS  Google Scholar 

  • McGraw, S. A., Smith, K. W., Schensul, J. J., & Carrillo, J. E. (1991). Socio-cultural factors associated with smoking behavior by Puerto Rican adolescents in Boston. Journal Social Science Medicine, 33(12), 1355–1364.

    Article  CAS  Google Scholar 

  • Merdad, L. A., Al-Zahrani, M. S., & Farsi, J. M. (2007). Smoking habits among Saudi female university students: Prevalence, influencing factors and risk awareness. Annals Saudi Medicine, 27(5), 366–369.

    Article  Google Scholar 

  • Mohammed, H. R., Newman, I. M., & Tayeh, R. (2006). Shisha smoking among a sample of future teachers in Kuwait. Kuwait Medical Journal, 38(2), 107–113.

    Google Scholar 

  • Nagelkerke, N. J. D. (1991). A note on a general definition of the coefficient of determination. Biometrika, 78(3), 691–692.

    Article  Google Scholar 

  • Nelson, C. B., & Wittchen, H. U. (1998). Smoking and nicotine dependence: Results from a sample of 14- to 24-year-olds in Germany. European Addictive Research, 4(1–2), 42–49.

    Article  CAS  Google Scholar 

  • O’Loughlin, J., Paradis, G., Renaud, L., & Sanchez Gomez, L. (1998). One-year predictors of smoking initiation and of continued smoking among elementary schoolchildren in multiethnic, low-income, inner-city neighborhoods. Tobacco Control, 7(3), 268–275.

    Article  PubMed  Google Scholar 

  • Peto, R., & Lopez, A. D. (2001). Future worldwide health effects of current smoking patterns. In C. E. Koop, C. E. Pearson, & M. R. Schwarz (Eds.), Critical issues in global health. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Qidwai, W., Ishaque, S., Shah, S., & Rahim, M. (2010). Adolescent lifestyle and behaviour: A survey from a developing country. PLoS One, 5(9), e12914.

    Article  PubMed  Google Scholar 

  • Rend, D. J., McNeill, A. D., & Glynn, T. J. (1995). Reducing the prevalence of smoking in youth in Western countries: An international overview. Tobacco Control, 4, 266–277.

    Article  Google Scholar 

  • Rowlands, D. F., & Shipster, P. J. (1987). Cigarette smoking amongst Saudi schoolboys. Saudi Medical Journal, 8, 613–618.

    Google Scholar 

  • Saeed, A. A., Al-Johali, E. A., & al-Shahry, A. H. (1993). Smoking habits of students in secondary health institutes in Riyadh City, Saudi Arabia. Journal Royal Social Health, 113(3), 132–135.

    Article  CAS  Google Scholar 

  • Santrock, J. W. (1995). Life span development (5th ed.). Madison: Brown & Benchmark Publ.

    Google Scholar 

  • Schultz, H., Ezzat, A., Allam, A., & Gray, A. (1998). Smoking and health: New insights and recent developments. Annals Saudi Medicine, 18(1), 1–5.

    CAS  Google Scholar 

  • Shamsuddin, K., & Haris, M. A. (2000). Family influence on current smoking habits among secondary school children in Kota Bharu, Kelantan. Singapore Medical Journal, 41(4), 167–171.

    PubMed  CAS  Google Scholar 

  • Siddiqui, S., & Ogbeide, D. O. (2001). Profile of smoking amongst health staff in a primary care unit at a general hospital in Riyadh, Saudi Arabia. Saudi Medical Journal, 22(12), 1101–1104.

    PubMed  CAS  Google Scholar 

  • Sonntag, H., Wittchen, H. U., Höfler, M., Kessler, R. C., & Stein, M. B. (2000). Are social fears and DSM-IV social anxiety disorder associated with smoking and nicotine dependence in adolescents and young adults? European Psychiatry, 15(1), 67–74.

    Article  PubMed  CAS  Google Scholar 

  • Soueif, M. I., Youssuf, G. S., Taha, H. S., Moneim, H. A., Sree, O. A., Badr, K. A., et al. (1990). Use of psychoactive substances among male secondary school pupils in Egypt: A study on a nationwide representative sample. Drug Alcohol Dependence, 26(1), 63–79.

    Article  CAS  Google Scholar 

  • Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA, 282(18), 1737–1744.

    Article  PubMed  CAS  Google Scholar 

  • Valdivia, G., Simonetti, F., Cumsille, P., Ramírez, V., Hidalgo, C. G., & Palma, B. (2004). Smoking habit in school age children, in Chile. Review Medicine Chile, 132(2), 171–182.

    Google Scholar 

  • Washio, M., Kiyohara, C., Morioka, S., & Mori, M. (2003). The experience of smoking in school children up to and including high school ages and the current status of smoking habits; a survey of male high students in Japan. Asian Pacific Journal Cancer Prevention, 4(4), 344–351.

    Google Scholar 

  • WHO. (1999). World No-Tobacco Day. (2010). Director-general of the world health organization for world no-tobacco day. Last Accessed February 1, 2010, from http://www.forces-nl.org/WHO/ADVISORY98.PDF.

  • WHO–EMRO (Eastern Mediterranean Regional Office). (2003). Country profiles, Egypt. WHO EMRO. Last Accessed December 25, 2009, from http://www.emro.who.int/emrinfo/CountryProfilesegy.html.

  • World Health Organization (WHO). (2001). Middle-East and North Africa (MNA) regional office. Tobacco in Middle-East and Northern Africa. WHO, Region Office for the Eastern Mediterranean Publication, report # 23, Geneva.

  • Zahran, F. M., Ardawi, M. S., & Al Fayez, S. (1985). Carboxyhaemoglobin concentration in smokers of shisha and cigarette in Saudi Arabia. British Medical Journal, 291, 1768–1770.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tarek Tawfik Amin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Amin, T.T., Amr, M.A.M. & Zaza, B.O. Psychosocial predictors of smoking among secondary school students in Al-Hassa, Saudi Arabia. J Behav Med 34, 339–350 (2011). https://doi.org/10.1007/s10865-011-9319-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-011-9319-7

Keywords

Navigation