Prevalence and determinants of smoking behavior among male school adolescents in Saudi Arabia

Child maltreatment and protection in the Arab Gulf Cooperation Council countries: A scoping review

BACKGROUND

Research on child maltreatment and protection in the Arab Gulf Cooperation Council countries-Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE)-is limited but growing, as is child protection as a sector.

OBJECTIVES

We aimed to identify themes and gaps in existing research on child maltreatment and protection, identify opportunities for building capacity in research and practice.

PARTICIPANTS AND SETTING

N/A.

METHODS

We conducted a scoping review of empirical studies published in peer-reviewed journals in English and Arabic and reported methods and findings according to the PRISMA-ScR reporting protocol. Articles were coded by country, topic of research, and type of abuse studied, if any.

RESULTS

Our database search returned 6109 articles and 160 articles were included in our review. Themes included (1) prevalence, incidence, and characteristics of maltreatment, (2) outcomes associated with maltreatment, (3) attitudes, awareness, and reporting, (4) accidental injury and death potentially associated with neglect, (5) policy and practice. Eighty-seven articles studied Saudi Arabia, while 28 studied the UAE, 21 Kuwait, 13 Qatar, 12 Oman, and 11 Bahrain. Physical abuse was studied in 77 articles, followed by sexual abuse in 54 articles and emotional abuse in 54.

CONCLUSION

Although the medical community produces an encouraging volume of child maltreatment research, gaps remain. Intervention research is lacking, and further inquiry into family dynamics, culture, and spirituality could inform the development of effective interventions. Cross-sectoral collaboration among education, social work, law enforcement, and healthcare is also needed to safeguard children's rights in the GCC.

Associations between self-rated health, life satisfaction and physical activity among adolescents in Saudi Arabia

Empirical evidence has shown that health status and life satisfaction are strongly correlated and connected to physical activity. However, no previous research has examined the association of physical activity (PA) with self-rated health (SRH) and life satisfaction (LS) among adolescents in Saudi Arabia. Therefore, a cross-sectional study was conducted among a sample of male adolescents (n=453; age 15–20 years) in Riyadh, Saudi Arabia. The objective was to investigate the association between LS and SRH with PA in adolescents, taking into account socio-demographic variables. A pre-tested validated questionnaire was used to collect data using a stratified sampling technique. An estimated 354 (78.5%) adolescents reported being healthy, and 98 (21.7%) were satisfied with their lives. The logistic regression analysis revealed that adolescents’ SRH was independently associated with their sense of LS (AOR=2.5, 95%CI: 1.5-4.3, P≤0.001). Also, the odds of reporting being healthy increased 2.5 times for being moderate active (95%CI: 1.5-4.3, P<0.001) and 3.4 times for being highly active (95%CI: 2.0-5.8, P≤0.001), as compared to non-active adolescents. Moreover, adjusted logistic regression showed that adolescents’ LS was independently associated with high level of their father’s education (AOR=1.8, 95%CI: 1.2-3.0, P=0.023); studying in private schools (AOR=1.9, 95%CI: 1.3-2.9, P≤0.011) and being highly active (AOR=3.0, 95%CI: 1.6-4.2, P=0.007). SRH and LS are determinants of each other, and both variables were independently associated with PA levels. Programs that increase PA may promote life satisfaction and health status in the adolescent population. Therefore, it is important to promote physical activity amongst them, create a sport-friendly environment, and engage adolescents in physical activity during their free time by broadening access to more sports classes and other forms of assistance. This is also an important method of enhancing adolescents’ life satisfaction and better health.

Towards a better understanding of factors affecting smoking uptake among Saudi male adolescents: A qualitative study

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Influence of Dental Pain and Tooth Sensitivity on the Intention to Quit Smoking among Schoolchildren

Objective

To evaluate the association between oral health problems and sociodemographic factors with the intention to quit smoking and join the tobacco cessation program among schoolchildren.

Materials and Methods

This cross-sectional study included a sample of 10–12 grade male students from public high schools in different cities of the Eastern province of Saudi Arabia. Schoolchildren responded to a pilot-tested questionnaire about self-reported oral health problems and the intention to quit smoking. Bivariate and multivariate logistic regression analyses were performed.

Results

Out of 587 schoolchildren, 199 were smokers with a smoking prevalence of 33.9%. Significantly higher proportions of smokers than nonsmokers had tooth sensitivity (P = 0.029) and dryness of the mouth (P = 0.001). Most smokers (75.9%) had a family history of smoking, and 51.8% started smoking within the last two years. Tooth sensitivity (56.3%), dental cavities (52.8%), and dental pain (44.7%) were highly prevalent among smokers. About one-third of smokers expressed their intention to quit smoking (38.2%) and join a smoking cessation program (33.7%). Tooth sensitivity (OR = 3.7, P = 0.004) and dental pain (OR = 2.84, P = 0.014) were significantly associated with quitting smoking. In addition, smokers with tooth sensitivity (OR = 3.22, P = 0.007) had higher odds of joining a smoking cessation program than those without tooth sensitivity. The smokers who started smoking within the last two years (OR = 3.97, P = 0.002) were more likely to quit smoking than those who initiated smoking for more than two years.

Conclusion

Oral health problems were highly prevalent among smokers. Tooth sensitivity was significantly associated with quitting smoking and joining a cessation program in children. The awareness about the adverse effects of smoking on oral health should be part of regional, national, and global tobacco prevention policies and programs.

Exploring health-risk behaviors related to road safety and car drifting among adolescents in Saudi Arabia: the co-occurrence of multiple risk behaviors

Objectives Adolescence is a fundamental stage of life where they go through huge changes and development. As a result, they are more likely to engage in behaviors that may jeopardize their life and health. The main objectives of this paper is to investigate risky-behaviors related to road traffic safety and dangerious car drifting among adolescents in Saudi Arabia. Methods This was a school-based cross-sectional study conducted among male school adolescents in Riyadh, Saudi Arabia. A multi-stage probability sampling technique was performed to recruit the participants. A total of 1,501 male adolescents were included in this study, studying in private and public high schools. Results A total of 78.7% of the students were found to be driving cars, which indicated that a high proportion of adolescents drive without a license. A total of 96% and 97.7% of adolescents do not use seat belt when driving nor when riding a vehicle as a passenger, respectively. Using helmet was a very rare practice among adolescents since only 1.4% and 2.0% wore a helmet when using non-motorized and motorized vehicles, respectively. Attending car drifting events, joining people while performing car drifting and actual performing car drifting were prevalent as 46.7%, 42.9%, 36.1%, respectively. About 58% of the adolescents reported not been taught about how to avoid traffic accidents, and 80% reported the need for more health education regarding traffic safety. The logistic regression analysis indicates adolescents car drifting was independently associated with adolescents' age (OR = 1.2; 95%CI = 1.1-1.3; p < 0.01), studying in private schools (OR = 1.2; 95%CI = 1.2-2.0; p≤ 0.015), being Saudi (OR = 2.5; 95%CI = 1.9-2.8; p < 0.001), do not like schools (OR = 1.7; 95%CI = 1.4-2.4; p < 0.001) and poor academic performance (OR = 1.7; 95%CI = 1.3-2.3; p < 0.001). Also, the adjusted logistic regression confirmed that car drifting was independently associated with several health risk behaviors including joining people performing car drifting, attending car drifting events, not brushing teeth, smoking behavior, want to use drugs, carrying weapons, and taking part in bullying others. Conclusion Large proportions of adolescents engage in multiple risky road traffic behaviors. Therefore, it is strongly advisable for policymakers and other stakeholders to devise national strategies that consider road safety and risky driving behaviors among adolescents and school students. This study calls for a strategic intervention plan to change the culture of risky driving through a structured and comprehensive curriculum in school settings.

Examining HIV and STIs Related Knowledge Among Male Adolescents in Saudi Arabia

Background:

Sexually Transmitted Infection (STI) is a major global cause of acute illness, long-term disability and death, with serious medical and psychological consequences. Knowledge and awareness about the transmission of sexual disease play an important role in the prevention of the disease. Very little is known about HIV and STI in adolescents and associated factors in Saudi Arabia.

Objective:

The aim of this study was to examine the association between self-rated STI knowledge and HIV and STI knowledge test scores, as well as to investigate the association between adolescents’ HIV and STI knowledge and their demographic background and sexually related behaviors.

Methods:

A multi-stage cross-sectional study was conducted using a self-administered questionnaire, recruiting 453 male adolescents (15 and 20 years) from private and public male high schools in Riyadh, the capital city of Saudi Arabia.

Results:

More than half (53.4%) of the adolescents reported their STI knowledge as excellent or good (42%). However, based on the total score scale of HIV and STI knowledge, 64.3% had a poor level of knowledge. The sexual information sources commonly cited were friends (70%) and internet (40.0%); and the least cited sources were fathers (16%) and mothers (15%). The logistic regression analysis revealed that adolescents’ father and mother education (>12 years) were positively associated with adolescent’s HIV and STI knowledge level (OR= 1.6, 95% CI: 1.1-2.4, p= 0.040) and (OR= 1.8, 95% CI: 1.2-2.8, p= 0.010). No significant association was found between adolescents’ HIV and STI knowledge and their sexual behaviors and attitudes.

Conclusion:

Findings suggest that a high proportion of male adolescents have poor HIV and STI related knowledge. Poor knowledge and reliance on potentially unreliable informational sources coupled with an over-estimate perception of STI expertise suggests that improvements in STI and HIV education should be addressed. Additional research is needed to help identify factors (beyond knowledge) associated with sexual behavior and attitudes that may increase the risk for STIs and HIV among adolescents.

Exploring Sexual Behaviour and Associated Factors among Adolescents in Saudi Arabia: A Call to End Ignorance

Little is known about sexual behaviour, attitudes, and associated factors among adolescents in Saudi Arabia. A cross-sectional study using a multistage sampling technique was conducted among 453 male adolescents selected from high schools in Riyadh, Saudi Arabia. About 54.1% of the adolescents practiced masturbation daily and 38% had experienced sexual contact, while 67% had friends who had experienced sexual contact. The majority of adolescents (72.2%) believed men engage in sexual experience before marriage, and only 11.5% discussed sexual health issues with their parents. Most adolescents believed in the effectiveness of sex education (92.3%) and the need for school-based sex education (85.6%). The logistic regression analyses showed adolescent sexual activity was independently associated with age [adjusted odds ratio (AOR) = 1.5, 95% confidence interval (CI): 1.3–1.8, p < 0.001), daily masturbation (AOR = 2.1, 95% CI: 1.3–3.2, p < 0.004), friends who engaged in sexual activity (AOR = 2.8, 95% CI: 1.4–4.6, p < 0.001), and belief that men experience sexual contact before marriage (AOR = 5.1, 95% CI: 2.8–9.3, p < 0.001). The findings indicated that male adolescents had negative attitudes toward sexual activity and were involved in risky sexual behaviour. To mitigate these issues, schools and community networks should be involved in the delivery of a culturally sensitive sexual health-promoting programme.

A systematic review of the prevalence and risk factors of smoking among Saudi adolescents

OBJECTIVES

To systemically review the evidence concerning the prevalence and reported risk factors of smoking among adolescents in Saudi Arabia. Methods: Following the PRISMA guidelines, studies that examined the prevalence and risk factors of smoking among adolescents in Saudi Arabia were identified through a computerized literature search using the following databases up to March 2018: PubMed, SCOPUS, Web of Science, and BIOSIS. The following search terms were used: smoking OR smok* OR tobacco OR cigar* OR shisha OR shesha OR sheesha AND Saudi Arabia OR KSA. Peer-reviewed articles published within the period from 2007 to 2018 were selected. Studies that reported prevalence data, patterns, and risk factors of smoking among adolescents were included. Extracted data from each study were tabulated, and data were narratively synthesized.

RESULTS

Thirty-two studies that reported the prevalence of smoking in the adolescent age group were included in the narrative evidence synthesis. These studies were conducted on secondary school students (n=11), college students (n=14), and an adolescent age group without educational specifications (n=7). According to published reports between 2007 and 2018, the prevalence of tobacco smoking among adolescents in Saudi Arabia ranged from 2.4% to 39.6%. Influence of friends, and family negligence were the most commonly reported risk factors for smoking. Conclusion: The prevalence of smoking is relatively high among adolescents in Saudi Arabia. The social influence of friends, teachers or parents, low academic performance, having spare time, living away from home, and the desire to relieve stress were the most commonly reported risk factors for smoking.

Factors associated with smoking initiation among Saudi male adolescents: A longitudinal study

INTRODUCTION

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.

METHODS

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. Chi-squared 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.

RESULTS

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 supportive-norms of parents and having high intention to smoke in the future (p<0.001) were at higher risk of being smokers.

CONCLUSIONS

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.

Prevalence of smoking among male secondary school students in Arar City, Saudi Arabia

INTRODUCTION

Tobacco is one of the leading preventable cause of death worldwide. Tobacco consumption among teenagers is a major public health problem, especially in developing countries. Younger smokers are more liable to smoking complications. The objectives were to evaluate the prevalence of smoking among male secondary school students in the Northern Borders region, KSA.

METHODS

A cross-sectional study was conducted in Arar city. Four schools were chosen randomly from 21 secondary schools. A total of 240 students responded to the pre-designed questionnaire. The questionnaire included questions on demographic factors, smoking behavior and knowledge about smoking hazards.

RESULTS

Prevalence of current smoking among male secondary school students is 40.8%. Cigarette smoking was the most common type (67.3%) followed by Shish smoking (22.4%). Few students (2.1%) reported other forms of smoking, example (Hashish). Of the studied group, 39.8% smoke on a daily basis with 29.6% of them smoke more than five cigarettes per day.

CONCLUSION

Smoking is a prevalent habit among teenagers. Special concern should be directed to smoking cessation campaigns with behavioral, legal and economic interventions.