Smoking tobacco prevalence among college students in the Kingdom of Saudi Arabia: Systematic review and meta-analysis

Prevalence of smoking and its associated factors among students of the University of Dongola, Northern State, Sudan: a cross-sectional study

Background

Smoking is one of the leading causes of morbidity and mortality worldwide, and its prevalence has increased globally, particularly among university students.

Objective

The study aimed to assess the smoking prevalence and its associated factors among students at University of Dongola, Northern State, Sudan.

Methods

A multi-centred cross-sectional study was conducted among students of University of Dongola. Data was collected via an online Google form questionnaire. Descriptive and comparative analyses were performed using SPSS, version 26. Statistical significance was considered at p less than or equal to 0.05.

Results

A total of 642 students participated in the study, of which 51.9% were females. Most of the students (73.6%) were aged 20-25 years and came from health & medical faculties (60.7%). The overall prevalence of smoking was 11.7%. The determined risk factors for smoking included male gender (P≤0.001), older age (P≤0.001), non-health and non-medical faculties (P≤0.001), uneducated fathers (P=0.032), and low socio-economic status (P=0.001). The most common reason for smoking was stress (36%), with cigarettes being the most commonly used type (88%). Personal savings were the main source of smoking expenses (73.3%). Most smokers (88%) were aware of the harmful effects of smoking.

Conclusion

The overall smoking prevalence was relatively low among students at University of Dongola. Male gender, older age, non-health and non-medical faculties, uneducated fathers, and low socio-economic status were significant risk factors for smoking. The majority of smokers were aware of the harmful effects of smoking.

Prevalence of Adverse Respiratory Symptoms Among E-Cigarette Users in Saudi Arabia - A Cross-Sectional Study

Electronic cigarettes, frequently referred to as e-cigarettes, have emerged as a controversial and rapidly growing phenomenon in the realm of tobacco and nicotine consumption worldwide. This study reports the prevalence of respiratory symptoms among e-cigarette users. This study also helps to understand the potential harmful effects and importance of quitting e-cigarette smoking. An observational cross-sectional study was carried out in Saudi Arabia. The study period was from September 2022 to August 2023. The sample size was 447 participants. Among recent e-cigarette users in this Saudi study, usage varied, with 44.1% using 1-5 days, 33.6% using 6-30 days, and 22.4% using e-cigarettes previously but not in the previous month. Vape devices were predominant (42.7%). There were significant associations emerged between e-cigarette use frequency and symptoms such as fatigue, breathlessness, and shortness of breath. E-cigarette use was notably linked to asthma-related symptoms, underscoring its concerning impact on respiratory health (P < 0.05). E-cigarette consumption has a significant impact on respiratory effects and specifically asthma-related symptoms among this Saudi population.

Drug Abuse Educational Program for Saudi University Students: A Pre-test and Post-test Design

Background and objective Designing a consistent preventive drug abuse program and evaluating the educational needs of diverse target groups, school curricula, and new instructional materials customized to a country's socioeconomic and cultural characteristics should be used. This research aims to assess the influence of an educational program on university students' awareness of drug abuse. Methodology A cross-sectional study using a pre-test questionnaire with predetermined questions was conducted with 102 participants. The educational program about drug abuse prevention measures was subsequently implemented. After the program was completed, a post-test was administered to the students, and the results were compared to the pre-test results. The data were collected from male and female Saudi students at a university in the western area of Saudi Arabia. Results The pre-test findings indicate that the students had already received some information on drug use and abuse, but the post-test results show that their awareness rose as a result of the drug abuse educational program. Conclusion Drug abuse is a major problem all across the world, including in Saudi Arabia. However, educational programs will help to increase knowledge and awareness of this issue.

University students' and staff attitudes toward the implementation of a "tobacco-free" policy: A view from Qatar

Objectives

Tobacco-free campus policies are needed to create environments conducive to prevention or quitting in the Eastern Mediterranean Region (EMR), where the use of various tobacco products is on the rise among university students. The objectives of this study were to assess overall support for a 100% tobacco-free campus policy and its predictors among different stakeholder groups at the largest national university in Qatar and to understand attitudes towards specific policy components.

Study design

A cross-sectional online survey of faculty and students.

Methods

We measured sociodemographic variables, tobacco use, and support for components of a 100% tobacco-free campus policy. A total score for support was calculated, and associations with selected predictors were assessed using multivariable linear regression.

Results

413 respondents participated in the survey. A majority of faculty/staff and students (76.6% and 75.5%, respectively) supported the implementation of a 100% tobacco-free campus policy, with a majority supporting extension of the policy beyond cigarettes. Support for other components of the policy varied. Among students, overall support was lower among males and tobacco users and higher among the married. Among faculty and staff, support was lower among Qatari nationals and tobacco users.

Conclusion

In the context of a growing tobacco crisis in the EMR, implementing and understanding the impact of tobacco-free campus policies is essential. This paper underscores the importance of addressing diverse stakeholder attitudes and providing empirical evidence to guide policy implementation and evaluation.

The Use of Electronic Cigarettes in Saudi Arabia: A Narrative Review

The use of electronic cigarettes (or "e-cigarettes") is spreading throughout the world. Population-level data from a number of countries indicate that e-cigarettes are used more by children and young adults than by the overall population. Although extensive research has been conducted in Western nations to better understand many aspects of e-cigarette usage among children and young adults, Middle Eastern nations have little data on this topic. The use of tobacco is detrimental to the health, finances, and national spirit of Saudi Arabia. More than 7,000 of its citizens die each year from diseases caused by tobacco use. Nevertheless, more than 20,000 youngsters and 3,352,000 adults smoke cigarettes each day. Similarly, the use of electronic cigarettes is on the rise, possibly as a result of aggressive publicity and marketing campaigns by manufacturers that appeal to the younger demographic. This review was undertaken through literature research to ascertain the usage and attitudes toward e-cigarette use among the Saudi population.

The Association Between Nicotine Dependence and Mental Health in the General Population of Saudi Arabia: A Cross-Sectional Analytical Study

Background

High prevalence of mental disorders is associated with psychoactive substances, significantly contributing to morbidity, disability, and premature mortality. Worldwide, individuals who use electronic-cigarettes (EC) and have a mental health diagnosis are more likely to experience stress, depression, and drug use. This study aims to measure the prevalence of both EC use and mental health disorders namely, anxiety and depression additionally to investigate the association between EC use and mental health status among the general population of Saudi Arabia.

Methods

A cross-sectional analytical study was conducted across Saudi Arabia from November 2022 to May 2023. The survey was divided into three sections. The first section focuses on the demographics, while the second part asked about both conventional and EC smoking and their frequency. The third section assessed mental health status using a Patient Health Questionnaire with a 9-item depression scale (PHQ-9) and a 7-item Generalized Anxiety Disorder scale (GAD-7).

Results

The study revealed 21.1% reporting EC use in the past thirty days. While 19.8% reported smoking tobacco one or more days within the last thirty days. Regarding mental health, 36.6% of individuals had minimal anxiety, while 42.4% experienced mild anxiety. Moreover, most of the participant were considered to have mild followed by minimal depression accounting for 36.7% and 31.9%, respectively. The results indicated a positive and significant correlation between perceived depression scores and nicotine dependence among EC users. Additionally, there was a strong relationship between gender and nicotine dependence, with men being more inclined than women.

Conclusion

There is a correlation between nicotine use and mental health outcomes; people who use nicotine products are more likely to experience anxiety and depression.

Epidemiology and incidence of oral squamous cell carcinoma in the Iraqi population over 5 years (2014-2018)

Background

Oral squamous cell carcinoma is one of the most common and life-threatening neoplasms worldwide, and is responsible for approximately 90% of all oral malignancies.

Aim

This study was aimed at providing updated information on oral squamous cell carcinoma in all Iraqi governorates for the 5-year period from 2014 to 2018, including the annual incidence and demographic variables.

Materials and Methods

The total number of oral squamous cell carcinoma cases in Iraq, along with associated demographic information (age, sex, and site), for the 5-year period from 2014 to 2018 was obtained. The statistical analysis consisted of descriptive analysis, including frequency, percentage, and mean ± standard deviation. A χ ² test was performed to compare frequencies between male and female patients, among age groups, and among different OSCC sites. The χ ² test was also used to assess the association of each OSCC site with age and sex. The significance threshold was set at p < 0.05, and the confidence interval was set at 95%. The incidence rate of oral squamous cell carcinoma for each year was calculated by dividing the number of OSCC cases per year by the population of Iraq, then multiplying the result by 100,000.

Results

A total of 722 cases were recorded. Statistically, oral squamous cell carcinoma was found to be more prevalent in males and individuals over 40 years of age. The tongue was the most common site of occurrence. Lip squamous cell carcinoma cases were high in males. The incidence rate of oral squamous cell carcinoma was estimated to be 0.4 per 100,000 people.

Conclusion

Males and older people are at relatively higher risk of developing oral cancer. The tongue is the most affected site, but any site in the oral cavity may be involved. Further exploration of the causes of oral malignancy in Iraq is necessary to improve prevention strategies.

Smoking Habits among College Students at a Public University in Riyadh, Saudi Arabia

Tobacco smoking is one of the leading risk factors for ill health and death worldwide. Adolescence is the starting age of smoking for most current smokers worldwide. This study aimed to explore the prevalence of tobacco, the habits of different types of former smokers, and their relationship to other specialties and sociodemographic data. Methods: This cross-sectional study was conducted at Imam Mohammad Ibn Saud Islamic University (IMSIU), Saudi Arabia. An online questionnaire was sent to students' emails to assess their smoking prevalence and tobacco and nicotine product habits. Results: Of the 895 students in IMSIU who participated in our survey, most reported having never used/tried tobacco, representing (76.4%). Most of the students who smoke began to smoke within the last five years (46.4%), which strongly indicates that they started to smoke when they entered the university. When students were asked about the time they like to smoke, most reported that they smoke when they feel stressed/under pressure (57.1%). There was a strong relationship between having a family member who smokes and being a smoker (53.1%). Conclusions: The prevalence of cigarettes, electronic cigarettes, and Shisha was 18.3%, 5%, and 11%, respectively. Anti-smoking regulations at the university level should be periodically reviewed to ensure the effectiveness and efficiency of tobacco control strategies.

Association of Sleep, Body Weight and Physical Exercise with Plasma BDNF Levels in Healthy Male Saudi Smokers

Introduction

Brain-derived neurotrophic factor (BDNF) has been shown to impact neural function and development. The BDNF plasma levels may be affected by a smoker’s behavior. Thus, the aim of this study was to investigate the association between sleep, body weight and physical exercise with brain-derived neurotrophic factor (BDNF) in healthy male Saudi smokers.

Methods

A cross-sectional study, with a convenience sample, was conducted during personal visits to the Anti-Smoking Clinic and Family and Community Medical Center of Imam Abdurrahman Bin Faisal University (IAU) in Dammam at the end of 2018. Blood samples were taken from participants to measure the BDNF plasma levels. Multiple linear regression analysis was used to examine the relationship between plasma BDNF levels and participants’ background characteristics, such as smoking index, physical activity, body mass index (BMI) and Pittsburgh sleep quality index (PSQI).

Results

A sample of 73 (31 smokers and 42 non-smokers) males took part in the study. The results demonstrated a significant relationship between plasma BDNF levels with physical activity, smoking age, smoking index, PSQI and BMI 25–29.9 (overweight). However, the results showed no significant relationship between plasma BDNF levels and BMI (healthy weight) and obesity.

Conclusion

This study shows that physical activity and sleeping quality can provide a positive impact against smoking-associated variation of the BDNF plasma levels, which may affect the health of Saudi males. Further investigation is needed to understand what other potential background characteristics are best predictive or correlated with BDNF plasma levels.

Alcohol and Nicotine Use among Adolescents: An Observational Study in a Sicilian Cohort of High School Students

In recent years, the mode of alcoholic intake known as binge drinking (BD) has become a common practice, especially among adolescents who, due to socio-environmental motives, tend to reach a rapid state of drunkenness. This drunkeness leads to alterations in brain areas responsible for executive functions and cognitive processes, as well as to the genesis of factors that predispose to lasting addiction. Likewise, nicotine leads to a comparable degree of addiction. On this basis, the aim of this research was to evaluate, on a cohort of 349 high school students (15−17 years old) in the province of Palermo, the following: (I) the drinking model of alcoholic beverages; (II) the use of nicotine and the degree of dependence; (III) the correlation between the consumption of alcoholic beverages and the use of nicotine. We employed the AUDIT-C test and the Fagerström test, two valid and standard instruments, in order to assess alcohol and nicotine use, respectively. Statistical analysis of the data showed that male and female students consumed alcohol prominently in a BD mode (77.2%, audit score (AS) 3.497, confidence interval (CI) 3.206−3.788; 69.6%, AS 2.793, CI 2.412−3.274) and nicotine (41.5%, Fagerström score (FS) 3.882, CI 3.519−4.245; 28%, FS 3.286, CI 2.547−4.024). Furthermore, a positive correlation between alcohol consumption and nicotine use was found for male (r = 0.6798, p < 0.0001) and female (r = 0.6572, p < 0.0001) students. This study provided further insights into the use of legal substances of abuse in adolescents, evidencing the obvious need for the promotion of specific school educational programs aimed at the wellbeing of youth populations.

Prevalence of Smoking and Beliefs and Attitude Toward Smoking Habit and Smoking Cessation Methods Among Pharmacy Students: A Cross-Sectional Study in Saudi Arabia

Objective

The impact of pharmaceutical services on public health especially in regards to smoking cessation counseling can influence the rate of smoking cessation. The present study aims to evaluate prevalence, beliefs, and attitude of pharmacy students toward smoking habit and SC methods.

Methods

An online cross-sectional survey was conducted among pharmacy students at King Saud University, Riyadh, Saudi Arabia over 4-month period from May to August 2021. The survey consisted of 22-items focused on evaluating the prevalence, belief, and attitude toward smoking habits and smoking cessation methods. Data was descriptively analyzed using a statistical package for social science version 26 (SPSS).

Results

A total of 675 students completed the survey, among which 78.7 % were non-smokers and only 31.7% received education on the dangers of smoking. The most common methods of smoking cessation they heard of were consultation (58.6%), followed by use of electronic cigarettes (41.92 %) and Nicotine patch (40.7%). One-third of the surveyed students (36.8 %) agreed that specialized smoking cessation clinics enhance the efficacy of smoking cessation methods. The majority of students (80.6%) agreed to ban smoking in public places and 92.2% believed that tobacco sales to adolescents should be forbidden. Health professionals should actively participate and advise their patients to quit smoking as 89.8 % students agreed on that. Age and gender of students had significantly influenced the prevalence of smoking, history of smoking, frequency of smoking, efforts to quit smoking among smokers (p = 0.0001).

Conclusion

The prevalence of non-smokers among pharmacy students is encouraging, yet level of awareness about and usefulness of smoking cessation methods is unsatisfactory. Therefore, the study clearly highlights a great need for integrating smoking cessation programs in their academic curricula to prepare them for real-world practice.

Tobacco Taxation Influences the Smoking Habits of Adult Smokers Attending Smoking Cessation Clinic in Saudi Arabia

Objectives

To determine whether the increased tobacco price due to tax implementation on tobacco products (including cigarettes) has a significant effect on smoking cessation among Saudi Arabian adult smokers.

Methods

An interviewer-administered questionnaire was used to obtain data from adult Saudi smokers and recent quitters attending smoking cessation clinics between January 2018 and September 2019. The responses of the participants were summarized and analyzed.

Results

In total, 660 participants were interviewed, of which 98% were men who resided in the western region (33%). Taxation had no effect on smoking in 387 participants [58.6%; 95% confidence interval (CI): 54.9, 62.4], some effect in 220 participants (33.3%; 95% CI: 29.7, 36.9), and a substantial effect in 50 participants (7.6%; 95% CI: 5.6, 9.6). Strategies adopted to cope with the tax implementation included cutting down on the number of cigarettes smoked (302; 45.8%), changing to a cheaper brand of cigarette (151; 22.9%), purchasing in bulk (105; 15.9%), attempting to quit (453; 68.6%), and doing nothing (108; 16.4%). The rate of quitting smoking after attending the clinic was 20.7% (95% CI: 17.7, 23.9). Occupation (P = 0.003), education (P = 0.03), and current smoking habit (P = 0.07) were significantly associated with the impact of tobacco taxation. The strategies adopted in response to tax implementation on cigarettes were significantly associated with occupation (χ2 = 30, degrees of freedom = 12, P < 0.001).

Conclusions

Tobacco taxation influenced 40% of the participants. Their attempts to opt for alternatives should be recognized in evaluating policies to reduce adverse health impacts caused by tobacco abuse.

Impact of taxation policy on tobacco consumption in Saudi Arabia

BACKGROUND

Taxes on tobacco products that increase the price and target demand-reduction have been shown to be an efficient means of reducing tobacco consumption. A new policy introduced in 2017 has increased the price of a 20-cigarette pack of the most popular brand to 27.50 SAR (7.33 USD) with the tax portion being 68.09%, which is within the yardstick recommended by the World Bank.

OBJECTIVE

Assess impact of taxes on cigarette consumption.

DESIGN

Retrospective econometric analysis.

MAIN OUTCOMES MEASURES

The annual importation of cigarettes containing tobacco (commodity code 24022000) in metric tons (as a proxy measure of consumption).

METHODS

An econometric analysis of cigarette prices and consumption was performed using the methods of the World Bank Economics of Tobacco Toolkit. The impact was assessed statistically through price elasticity of cigarette demand. The study used yearly data for the period 2013-2019 to compare the price elasticity of demand according to the change in price. Cigarette consumption was equated to cigarette imports (dependent variable), and correlation with the cigarette price, income, education, and unemployment was assessed as independent variables of interest.

RESULTS

Annual importation of cigarettes declined by 27.41% for the period 2013-2019 after the imposition of ad valorem and value-added taxes in 2017 and 2018, respectively. The price of a pack of cigarettes increased by 115.1% from 2016 to 2018. The per capita consumption was inversely correlated with price *P=.0003285, r=-0.969). The inverse correlation between income and per capita consumption was also statistically significant (P=.025, r=-0.816). Education did not correlate with per capita consumption (P=.740, r=-0.155), but unemployment was inversely correlated (P=.008, r=-0.884). From 2016 to 2018, the price elasticity of demand became negative with respect to income as recommended by the World Health Organization. The price elasticity of demand reached -0.07, -0.8, -0.93 in 2016, 2017, 2018, respectively.

CONCLUSION

The modification of tax policy in 2017 has resulted in a decrease in both cigarette affordability and consumption. An additional 42.67% increase in the price, or pack price of 35.81 SAR (9.54 USD) might offset the increase in individual income noted in 2019 and maintain the decreased affordability.

LIMITATIONS

The lack of more granular data on cigarette sales and more reliable data on prevalence.

CONFLICT OF INTEREST

None.

Explaining the Craving for Cigarette Smoking Based on Adverse Childhood Experiences and Subjective Socioeconomic Status among University Students in Isfahan, Iran

Background: Adverse childhood experiences are linked to a wide range of physical, social, sexual, and family dysfunctions. These experiences, such as smoking, may have negative health consequences. Objective: The goal of this study was to explain the desire to smoke in university students in Isfahan, Iran based on adverse childhood events and subjective socioeconomic status. Methods: This cross-sectional study was conducted on 450 young adults who were recruited randomly from Isfahan universities in 2020. To collect data, a checklist of adverse childhood events, craving for smoking, and a question about subjective socioeconomic status were used. Multivariate logistic regression was used to analyze the data. Results: According to the findings, 46.5 percent of all university students had at least one Adverse Childhood Experience, and 68.8 percent of all university students had some level of smoking craving. Controlling for demographic variables, respondents with one to five adverse childhood experiences (OR: 1.84; 95 percent of CI: 1.11-3.04) and six or more adverse childhood experiences (OR: 5.37; 95 percent of CI: 2.58-11.71) were more likely to crave smoking than respondents with no adverse childhood experiences. Furthermore, among all students, a higher subjective socioeconomic status reduced the likelihood of smoking by 19%. Conclusions and implications: It can be concluded that university students who have had adversity in their childhood are more likely to engage in high-risk behaviors like smoking. Because smoking is recognized as a coping mechanism for stressful events, it is suggested that personal, local, and national strategies aimed at young adults in Iran be developed.

Influence of a University Tobacco-Free Policy on the Attitudes, Perceptions of Compliance, and Policy Benefit Among the University Students: A Pre-Post Investigation

Objective: To evaluate the effectiveness of a university tobacco-free policy by examining differences in students' attitudes, perceptions of compliance and policy benefits, after one year of the policy's implementation. Methods: Cross-sectional studies were undertaken to collect data pre- and 1 year post-policy implementation. The two samples were selected using stratified random sampling. Results: The prevalence of smoking decreased from 26% pre-policy implementation to 21% 1 year after (p = 0.035). The proportion of smokers who thought the policy had contributed to a reduction in smoking frequency increased from 10% to 70% (p < 0.001). Smokers' support for the policy rose from 42 to 58% (p = 0.007). Conclusion: Against the background of a strongly pro-tobacco environment in Lebanon, it is possible to create a positive change in the mindset of smokers at the levels of the education and smoking cessation and more efforts should be expended to bring it about.

"We cannot stop smoking": Female university students' experiences and perceptions

BACKGROUND

While findings are available about smoking in young females, there is a dearth of research reporting this problem among Jordanian females, particularly university students. Also, there is lack of studies that describe the daily experience and the causative factors for smoking among female university students.

PURPOSE

The purpose of this study is to describe the experience of smoking as perceived by female Jordanian university students. In addition, this study aimed to describe the predisposing factors for initiating smoking and feelings toward that experience.

METHOD

A descriptive qualitative study was employed. A purposive sample of 12 female Jordanian university students who smoke cigarettes were asked to participate in this study. A semi-structured, face-to-face interviews were conducted.

RESULTS

Five themes of the study included: (1) living and enjoying smoking with other females, (2) hazardous effect of smoking, (3) our culture stigmatizing female smoking, (4) why we don't stop smoking, and (5) strategies to combat smoking among females.

CONCLUSION

Female university students disclosed peer pressure and stress as intensifying factors for smoking. Also they were unable to quit smoking because they were attached and addicted to smoking cigarettes.

STUDY IMPLICATIONS

The findings of our study have several implications for nursing education, policymaking, and practice. An important target would be to motivate university students who are smokers to attempt smoking cessation leveraging cultural leaders as role models. Policy makers also should revise policies related to importing and taxation of cigarettes is essential. In addition, policy makers should enforce legislation for smoking fee areas and prevention of smoking in closed areas.

Predictors of waterpipe smoking among university students in the Qassim region, Saudi Arabia

INTRODUCTION

Waterpipe smoking has gained global popularity among adolescents and young adults. This study aimed to identify the predictors of waterpipe smoking among university students in the Qassim region of Saudi Arabia.

METHODS

A cross-sectional study was conducted using a pre-tested, validated, and self-administered questionnaire to identify the predictors of waterpipe smoking among university students aged >18 years in the Qassim region.

RESULTS

Of the 1158 questionnaires distributed, 928 were returned with complete responses. Of these 928 participants, 820 were men (88.7%) and the majority were unmarried (95.6%). The risk of waterpipe smoking was significantly higher in students aged >26 years (OR=3.39; 95% CI: 1.30– 8.80), those who had a brother who smoked (OR=1.78; 95% CI: 1.13–2.79), and those who were married (OR=3.21; 95% CI: 1.36–7.59). Furthermore, participants who had smoked cigarettes (OR=3.18; 95% CI: 1.89–5.34) or other tobacco products (OR=6.39; 95% CI: 3.69–11.07) within the past 30 days, and students who believed that waterpipe smoking was less harmful than cigarette smoking (OR=2.61; 95% CI: 1.54–4.41) had a higher risk of engaging in waterpipe smoking. However, the risk was lower among students receiving a monthly financial aid of more than US$264 (OR=0.34; 95% CI: 0.13–0.89).

CONCLUSIONS

This study revealed that higher age, being male, being married, low student financial aid, waterpipe smoker sibling, cigarette and other types of tobacco smoking in the past 30 days, and believing waterpipe smoking to be less harmful than cigarette smoking, were significant predictors of waterpipe smoking. Educational programs targeted at improving awareness of the adverse effects of waterpipe smoking should be considered for early prevention in young adults.

The prevalence of E-cigarette uses among medical students at Umm Al-Qura University; a cross-sectional study 2020

BACKGROUND

Electronic cigarette (e-cigarette) is becoming increasingly popular worldwide, and commercially a commonplace in the media. Health concerns and the avoidance of smoking are the most frequently reported factors for conventional smokers to turn to e-cigarettes. However, there is insufficient information about the use of e-cigarettes in Makkah city; therefore, this study aims to determine the prevalence of electronic cigarette uses among medical students at Umm al-Qura University (UQU).

METHODS

A cross-sectional study was conducted in February 2020 among medical students at UQU, Makkah, Saudi Arabia. Data were collected using a prevalidated printed version of a self-questionnaire to determine the prevalence and the main factors that influence medical students to smoke e-cigarettes and to evaluate their awareness, knowledge, and attitude.

RESULTS

Out of 1249medical students, 910 participated in the survey, about 31.8 % of them confirmed using e-cigarette regularly. 14.7% think e-cigarettes are medically approved method for smoking cessation, while 59.5% believe it can cause addiction similar to tobacco cigarettes. Among the regular users, 24.3% used it to quit tobacco smoking, 18.9% think it is less harmful, 20.3 % use it because it is less costly, and 18.9% because of stress. Also, 28.4% found it tasty. 30.8% believed that it is less harmful, about 74% stated that they received information about e-cigarettes and only 16% of them received it from medical school.

CONCLUSION

The prevalence of e-cigarette uses among medical student in UQU found to be relatively high, and their overall knowledge is insufficient, which conflict our hypothesis.

Knowledge, attitude, and beliefs toward group behavior therapy programs among male adults attending smoking cessation clinics, cross-sectional analysis

Background

Group therapy assists individuals in learning many behavioral techniques for smoking cessation and providing each other with mutual support. Group behavior therapy is not routinely provided as a modality of tobacco cessation assistance in tobacco cessation clinics in Saudi Arabia despite it is effectiveness. Therefore, this study aimed to assess the knowledge, attitude, and beliefs toward group behavior therapy programs among male adults who attend smoking cessation clinics and to identify the associated factors.

Methods

A cross-sectional study was conducted with a targeted sample of 229 males aged 18 and above who were attending smoking cessation clinics. The participants were randomly selected. Data were collected using a paper-based questionnaire. One-way ANOVA and chi-square test were used for statistical analysis.

Results

Results showed a high percentage of the study participants were in the age group of 21–40 years. Most of them were consuming 10–20 cigarettes per day. Around 79% of the participants had previous attempted to quit smoking. This study demonstrated a deficit in knowledge about group behavior therapy. The mean score for attitude and beliefs was 5.3 out of 11. Multiple factors influenced their attitudes and beliefs, such as previous attempts to quit smoking (p-value < 0.05) and the number of cigarettes used per day (p-value = 0.03). The knowledge was found to be affected by the level of education (p-value = 0.04).

Conclusion

The study demonstrates a deficit in knowledge about group behavior therapy and it shows that the level of education was associated with the knowledge. Additionally, previous attempts to quit smoking and the number of cigarettes used per day, influenced the participants’ attitude and beliefs toward group behavioral therapy. Increase awareness about the role of group behavior therapy in smoking cessation is required before this method is implemented in the routine practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10924-4.

Smoking among High School Students in Iran: A Meta-Analysis Study

Objective: Cigarette smoking is an important and preventable risk factor, especially for adolescents and high school students. This issue has become one of the challenges for health system. Thus, the present study aimed to investigate the prevalence of smoking among Iranian high school students.

Method: This systematic review and meta-analysis study was done by searching PubMed, Scopus, Web Science (WOS), Science Direct, SID, and Google Scholar using the following keywords: “student” and “smoking” from 2000 to March 2018. After initial and critical appraisal, data were entered into a checklist and analyzed by a comprehensive meta-analysis software.

Results: The prevalence of smoking was 7.9% by combining the results of 49 articles. Males and females had 10.6% and 4.5% smoking prevalence, respectively. The overall prevalence of smoking was higher in northern areas in Iran (22.4%). Males in the northern (22.4%) and females in western regions (5.3%) were more smokers. There was a significant relationship between the prevalence of smoking with the year of publication, sample size, and age (P < 0.001).

Conclusion: In this study, Students' tendency to smoke was different in various regions of Iran, and had a high rate (7.9%). This figure indicates the necessity for planning some coherent educational programs for the public.

The Prevalence of Substance Misuse and its Effects among Omani College Students: A Cross-sectional Study

Objectives

Many studies have confirmed that the use of alcohol, tobacco, and cannabis is prevalent among university students. This study aimed to assess the prevalence of substance misuse among college students in Oman, identifying the most commonly used substances, and reviewing the effect of substance misuse on the students’ performance.

Methods

This cross-sectional study was conducted in a higher learning institution in an urban setting in Oman from April 2018 to December 2018. A descriptive, self-administered online questionnaire, the Alcohol, Smoking, and Substance Involvement Screening Test, version 3.0 (Arabic version), adapted from the World Health Organization was sent to 12 000 students at the college. The sample size was calculated using online software (Raosoft), with a margin of error of 5% and a confidence level of 95%.

Results

A total of 375 students responded (response rate = 3.1%). The overall lifetime prevalence for any substance misuse (including tobacco and alcohol) among the participants was 41.3%, with the overall prevalence without tobacco or alcohol at 29.9%. Tobacco was the most common substance used, with a prevalence of around 23.5%, followed by alcohol at 10.7%. Male students had a significantly higher rate of substance abuse, for any substance, compared to female students (p < 0.001). There was a significant correlation between tobacco use, alcohol misuse, and misuse of other substances. Most of the adverse effects attributed to substance misuse reported by the respondents in this study were social (27.7%) and health-related (25.8%) problems. The impact of substance abuse on their performance was also high (23.8%). Furthermore, 15.4% of the respondents had financial problems, and 4.7%% were struggling with legal issues. Notably, only 49.1% of the respondents perceived that substance misuse was a serious problem.

Conclusions

Although college students are expected to be more aware of the negative impacts of substance misuse, this study found a high prevalence of smoking, alcohol, and other substance misuses among the group of Omani college students. Further research in this field is essential, and the results of this study have shed light on a critical problem among Omani college students. It is hoped that the findings of this study will be used and built on in future research to recognize students at risk of substance misuse from early school life, leading to early intervention, and potentially preventing the possible negative consequences.

Levels and factors of knowledge about the related health risks of exposure to secondhand smoke among medical students: A cross-sectional study in Jeddah, Saudi Arabia

INTRODUCTION

Secondhand smoke (SHS) appears to be an insidious public health issue in Saudi Arabia, with a high percentage of people being reportedly exposed. In an attempt to raise awareness about this issue, we explored medical students' level of knowledge about SHS risks, as well as their levels of exposure to SHS and the correlation between knowledge and exposure.

METHODS

A cross-sectional study was conducted in February 2020 at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. An online, modified version of a validated questionnaire was distributed among 2nd to 6th year medical students. The questionnaire mainly explored the following items: 1) exposure level to SHS; 2) impact of SHS exposure; and 3) knowledge about SHS related health risks, with calculation of a knowledge score (range: 0-8). Adequate knowledge was defined as a score ≥5 (median = 5), and associations with sociodemographic and lifestyle factors and exposure to SHS were analyzed using chi-squared and independent t-test, as appropriate.

RESULTS

Of a total 416 participants, 65.0% declared having one or more smoking persons among acquaintances, 26.4% being exposed to SHS at home, and 40.1% exposed to parental smoking during childhood. Further, 79.8% reported being regularly exposed to SHS in public places. Majority of participants reported significant discomfort (53.2%) and physical symptoms (98.3%) subsequent to SHS exposure. Among the list of 8 health risks, ear infection in children (28.1%), heart attack in children (37.5%), and cognitive deficit (47.8%) were the least frequently identified. Adequate knowledge was found among 57.5% of the participants, and was higher among females and lower among participants living with their friends, compared to their counterparts (p<0.05). No association of knowledge level was observed with the parameters of exposure to SHS and poor discomfort feeling.

CONCLUSIONS

The level of knowledge of medical students about health risks related to passive smoking is inadequate, while their exposure to SHS in public places is still substantial. This urges for the reinforcement of tobacco control strategies and highlights the great interest for medical colleges to implement effective educational interventions by improving their curricula regarding the risks of SHS and the benefits of smoking cessation.

Smoking Cessation Beliefs Among Saudi University Students in Qassim Region, Saudi Arabia

Introduction

Despite Saudi officials initiating a variety of smoking cessation programs, smoking in the country has not decreased. Thus, the objective of this study was to identify the factors associated with Saudi students’ beliefs about available smoking cessation interventions.

Methods

A cross-sectional, pre-tested, and validated paper-based survey was administered to a cohort from a university in the Qassim region. Bivariate analyses and logistic regression were conducted to explore the factors associated with the students’ beliefs regarding behavioral and pharmacotherapy interventions for smoking cessation.

Results

Out of 1158 surveys distributed, 958 responses were received (82.7% response rate). Students aged >23 years were more likely to believe in a behavioral intervention (marginal effect = 10.4%; 95% CI, 2.3%–18.6%). However, the respondents who indicated that they had smoked a hookah over the past 30 days were less likely to believe in either the pharmacotherapeutic (marginal effect = -7.9%; 95% CI, −15.6 to −0.3%) or the behavioral (marginal effect = -8.1%; 95% CI, −16.2% to −0.1%) interventions. Students who believed that the hookah was the same as or less harmful than cigarettes (marginal effect = −25.6%; 95% CI, −34.7% to −16.6%) and (marginal effect = −12.3%; 95% CI, −22.3% to −2.3%), respectively, were less likely to believe in pharmacotherapeutic interventions. Multiple logistic regression analyses found that hookah smokers with a willingness to quit smoking were more likely to believe in the effectiveness of cessation medications (marginal effect = 42.9%; 95% CI, 28.2%–57.6%) and behavioral interventions (marginal effect = 28.6%; 95% CI, 9.3%–48.0%).

Conclusion

This study found that smoking a hookah and its harmfulness were negatively associated with smoking cessation medications interventions. Regarding beliefs about behavioral interventions, while age was positively associated, hookah smoking and its harmfulness had a negative association. Willingness to quit smoking was positively associated with both medication and behavioral interventions.

Prevalence and predictors of midwakh smoking among male students of Qassim University, Al-Qassim, Saudi Arabia

INTRODUCTION

Novel tobacco products are becoming more popular in the Middle East and especially in Saudi Arabia. We studied the prevalence of midwakh pipe (tobacco smoking pipe) use among students at Qassim University and evaluated factors associated with midwakh pipe usage.

METHODS

A cross-sectional study was conducted using a self-administered questionnaire to collect the data. The participants were male students from Qassim University, Al-Qassim, Saudi Arabia. Data were collected over the period from May to June 2018. A multivariable logistic regression model was used to identify sociodemographic factors and smoking history related to midwakh smoking.

RESULTS

A total of 316 responses were collected; 7.9% (n=25) were midwakh smokers at some point, and 3.8% (n=12) were current midwakh smokers. Multivariable logistic regression indicated that the significant predictors of midwakh smoking among male university students were having a friend who is a tobacco or midwakh smoker, and consuming other forms of tobacco other than midwakh.

CONCLUSIONS

Having midwakh smoking friends, having friends smoking any other form of tobacco, and being a smoker could predict the use of midwakh among university male students in Saudi Arabia. Interventions are required to control this behavior to prevent smoking-related health consequences.

Factors associated with tobacco smoking among Saudi college students: A systematic review

INTRODUCTION

There has been an increase in tobacco smoking among Saudi college students in recent years. However, no study has examined, with a systematic approach, the extent to which specific factors are associated with tobacco smoking among this population.

METHODS

PubMed, ProQuest, CINAHL, and Web of Science were utilized to retrieve studies addressing risk factors associated with tobacco smoking among Saudi college students between 2010 and 2019. After confirming their eligibility criteria, studies were imported to the NVivo software for data collection and synthesis. All included articles were critically appraised, based on a modified STROBE.

RESULTS

Twenty-one out of 300 studies met the eligibility requirements for inclusion. Riyadh was the location, health-related science was the field of study, and male the gender of the population of most of the included studies. Only one study used a longitudinal design based on a theoretical framework, the rest were cross-sectional and lacked theoretical utilization. Four individual and two social factors were established to have a significant relationship with tobacco smoking behavior among college students in four or more studies. Environmental factors were found to be associated with a change in smoking behavior among Saudi college students based on two studies.

CONCLUSIONS

There is a dearth of research in utilizing theoretical frameworks to guide the research in order to propose an intervention program among Saudi college students. Future research should aim to recruit participants from different institutions in the Kingdom of Saudi Arabia (KSA), apply other methodological approaches, test other measurements of tobacco smoking, and utilize a theoretical framework.

Prevalence and perceptions of e-cigarette use among medical students in a Saudi University

Background and Aims:

We hypothesized that the prevalence of electronic cigarette vaping among the medical student population is on the rise. Our aims were to assess the prevalence of electronic cigarette vaping among medical students in Saudi Arabia, to understand and analyze the reasons that led them to try it, and to investigate students’ perceptions towards electronic cigarette vaping.

Methods:

An anonymous, paper-based, cross-sectional questionnaire was distributed amongst 401 undergraduate medical students from years 1-5 at Alfaisal University in Riyadh, Saudi Arabia. Prevalence, intensity of e-cigarette use and reasons for it, relation of electronic cigarettes to cessation of tobacco smoking, and side effects were studied.

Results:

The prevalence of vaping was 49/401 (12.2%). There was a strong association between gender and vaping, with males being 3 times more likely to vape compared to females (χ2 (1) =13.62, P <.001). The three most common reasons for using electronic cigarettes were to enjoy the variability in flavours (61.4%, n = 30), to reduce or quit tobacco cigarettes (29.5%, n = 14), and to avert the public smoking ban (13.6%, n = 7). The three most common side effects experienced by users were coughing (26.7%, n = 13), dry mouth/throat (24.4%, n = 12), and dizziness (20%, n = 10).

Conclusion:

Use of the electronic cigarettes is not uncommon amongst medical students, mostly due to their appealing flavor variability. Further research is required to define long-term safety and side effect profiles, and to generate evidence-based guidelines concerning e-cigarette safety and efficacy for smoking cessation.

Prevalence and Factors Associated with Current Cigarette Smoking among Ethiopian University Students: A Systematic Review and Meta-Analysis

Background

Although tobacco use is highest in high-income countries, most tobacco-related deaths occur in low- and middle-income countries with the highest number of deaths recorded in East Africa. The aim of this systematic review and meta-analysis is to determine the pooled prevalence and associated factors of current cigarette smoking among Ethiopian university students.

Methods

The authors searched databases from PubMed, PsycINFO, Google Scholar, EMBASE, and Web of Sciences. The publications included in the analysis were inclusive, the literature was searched from January 2011 to December 2018. The JBI-MAStARI critical appraisal tool was applied to 13 publications identified by the database search. I² statistics were used to indicate heterogeneity. Publication bias was evaluated using the visual funnel plot. A p value < 0.1 was considered as indicative of statistically significant publication bias. A random effect meta-analysis model was computed to estimate the pooled prevalence of cigarette smoking, and the variables associated with cigarette smoking were examined.

Results

The meta-analysis of 13 studies showed that the pooled prevalence of current cigarette smoking was found to be 12.55% (95% CI: 10.39–14.72; I² = 94.0%) with no publication bias according to Egger's test (p = 0.007) for cigarette smoking by 2.05 (95% CI: 1.52–2.75). Factors associated with cigarette smoking were peer influence 2.79 (95% CI: 1.62–4.82; I² = 35.7), khat chewing (95% CI: 2.81–15.26; I² = 82.5), and alcohol use 11.16 (95% CI: 7.46–16.71).

Conclusion

Our findings indicate a high prevalence of cigarette smoking among Ethiopian university students as compared to the general population. Gender, peer influence, khat chewing, and current alcohol use were significantly associated with cigarette smoking. The authors recommend promoting antismoking campaigns, emphasizing health hazard public service announcements about cigarettes, and integrating health education on smoking in youth-friendly services, especially targeting higher educational institutions.