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Predicting Tobacco Use Among High School Students by Using the Global Youth Tobacco Survey in Riyadh, Saudi Arabia

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Predicting Tobacco Use Among High School Students by Using the Global Youth Tobacco Survey in Riyadh, Saudi Arabia [Downloaded free from http://www.thoracicmedicine.org on Thursday, September 06, 2012, IP: 41.233.135.148] || Click here to download free Android application for this journal Original Article Predicting tobacco use among high school students by using the global youth tobacco survey in Riyadh, Saudi Arabia Mohamed S. Al Moamary, Mohammed O. Al Ghobain, Sulieman N. Al Shehri1, Ahmed Y. Gasmelseed2, Mohamed S. Al-Hajjaj3 College of Medicine, Abstract: King Saud bin OBJECTIVE: To identify the predictors that lead to cigarette smoking among high school students by utilizing the Abdulaziz University global youth tobacco survey in Riyadh, Kingdom of Saudi Arabia (KSA). for Health Sciences, METHODS: A cross‑sectional study was conducted among high school students (grades 10–12) in Riyadh, KSA, 1School Health between April 24, 2010, and June 16, 2010. Department, Ministry RESULTS: The response rate of the students was 92.17%. The percentage of high school students who had previously of Education, 2King smoked cigarettes, even just 1–2 puffs, was 43.3% overall. This behavior was more common among male students Abdullah International (56.4%) than females (31.3%). The prevalence of students who reported that they are currently smoking at least Center for Medical one cigarette in the past 30 days was 19.5% (31.3% and 8.9% for males and females, respectively). “Ever smoked” Research, 3College of status was associated with male gender (OR = 2.88, confidence interval [CI]: 2.28–3.63), parent smoking (OR = 1.70, Medicine, King Saud CI: 1.25–2.30) or other member of the household smoking (OR = 2.11, CI: 1.59–2.81) who smoked, closest friends who smoked (OR = 8.17, CI: 5.56–12.00), and lack of refusal to sell cigarettes (OR = 5.68, CI: 2.09–15.48). University, Riyadh, Saudi Arabia CONCLUSION: Several predictors of cigarette smoking among high school students were identified. Key words: Address for Adolescents, cigarettes, Saudi Arabia, tobacco correspondence: Dr. Mohamed S. Al Moamary, College of Medicine, ortality due to tobacco use continues to rise system is intended to enhance the capacity of King Saud bin Abdulaziz Mworldwide and is expected to cause ten countries to design, implement, and evaluate University for Health million deaths by the year 2020.[1,2] This public tobacco control and prevention programs. While Sciences, P.O. health problem has led to initiatives in developed the GYTS provides a standardized methodology Box 84252, Riyadh countries to ban smoking and implement effective process in terms of sampling size, data collection, 11671, Saudi Arabia. antismoking measures, which has resulted in an data management, and processing technique, it is E-mail: almoamary@ yahoo.com almost 50% drop in tobacco consumption over flexible enough to be used in different cultures. In the past three decades.[3] However, in developing the KSA, Al- Bedah et al. used the GYTS among Submission: 10-04-12 countries, tobacco consumption continues to intermediate-level school students (7th-9th grades) Accepted: 23-04-12 increase by approximately 3.4% annually.[4,5] The in 2001–2002 and 2007.[12] However, a major non-communicable disease risk factors standard limitation of this study is that the 2001 survey report from the Kingdom of Saudi Arabia (KSA) on included only male students. These surveys 2005 revealed that 20.9% of men and 1.4% of women showed that between 2001–2002 and 2007, there were current smokers.[6] Other local literature was a trend toward increased cigarette smoking suggests that the prevalence of tobacco use may be among male students, indicated by increases in Access this article online as high as 34%.[7-10] Moreover, women and young the number of students who reported that they Quick Response Code: adults are increasingly using tobacco. [11,12] To had tried smoking (from 34.5% to 39.5%) and address the problem of youth smoking, the World students who currently smoked (from 10.8% Health Organization, together with the United to 13.0%). Moreover, there was an increase in the States Center for Disease Control and Prevention number of students who wanted to try smoking and the Canadian Public Health Association, (from 6.7% in 2001–2002 to 20.6% in 2007). We has established the global youth tobacco survey have also previously reported that the prevalence (GYTS) as part of the global tobacco surveillance of ever smoked was 42.8% and current smoking [13,14] [15] Website: system. The GYTS is a school-based survey that was 19.5%. Thus, our objective was to identify www.thoracicmedicine.org collects data on students aged 13 to 15 years using the predictors that may lead to tobacco product a standardized methodology for constructing consumption by utilizing data collected through DOI: the sample frame, selecting schools and classes, the GYTS among high school students in Riyadh, 10.4103/1817-1737.98843 and processing data. The GYTS surveillance KSA. 122 Annals of Thoracic Medicine - Vol 7, Issue 3, July-September 2012 [Downloaded free from http://www.thoracicmedicine.org on Thursday, September 06, 2012, IP: 41.233.135.148] || Click here to download free Android application for this journal Al Moamary, et al.: Predicting tobacco use among high school students Methods least once during the previous 30 days. “Ever smokers” were defined as students who had ever smoked even just one or two We conducted a cross-sectional study using the GYTS among puffs. Those ever smokers that are not current smokers were high school students in Riyadh, KSA, between April 24, 2010 labeled as “non-current smokers.” “Never smoked” are those and June 16, 2010. who never have tried smoking. “Ever smoked” are those who tried smoking even one-two puffs. Sample size and selection A modified standardized methodology for conducting the Ethical approval and consent GYTS was applied. The main deviation was applying it on This study is part of a survey that was conducted to address age group 15-18 years and analyzing items in the GYTS asthma and smoking. Permission to perform the study was questionnaire pertained to the study objective. This age group obtained from the Ministry of Education. Ethical approval is correspondent to high school, a three-year phase of the was obtained from the research and ethics committee of the education system in the KSA. Schools and participants were Saudi Thoracic Society. Verbal consent from students was selected by a two-stage cluster sampling method. Riyadh is obtained after explaining the purpose of the study in detail the capital of the KSA with a population of approximately and confirming the confidentiality in handling and storing the five million habitants. The city has 405 high schools, surveys, which kept each questionnaire anonymous. with 160 (39.5%) for boys and 245 (60.5%) for girls. There are also 185 private schools (45.7% of total schools), which provide Statistical analysis education for both genders segregated into two different Data were analyzed using SAS V9.1 software (SAS Institute, buildings. For sampling purposes, each gender-based section NC). The variables were summarized and reported using was considered as a school. Of the 161 223 high school students descriptive statistics. Categorical variables were reported using in the academic year of 2009–2010, 83 056 (51.5%) students frequency distributions and proportions. Analytic statistics were boys and 78 167 (48.5%) were girls. For the purposes of for logistic regression were used to analyze the relationship sampling, we divided the city of Riyadh into four parts based between dependent variables and some independent variables, on the location of two major highways, King Fahd Road and and the results are reported in terms of odds ratios, 95% Khurais Road. The next stage of cluster sampling collection confidence interval (CI), and P value. A P value ≤ 0.05 was involved random selection of classrooms within each school. considered significant. A total of 46 schools (11.4%) with 20 034 students (12.4%) were included. This sample included 9 971 boys (49.8%) and 10 063 girls (50.3%). Based on the probability proportional sample Table 1: Questions selected from the global youth technique using different regions and schools, 10% of the tobacco survey schools from each part of the city were selected. Twelve schools 1. Have you ever tried or experimented with cigarette were selected from the northern section of the city (6 boys’ smoking, even one or two puffs? schools and 6 girls’ schools), 10 schools were selected from 4. During the past 30 days (one month), on the days you the southern part (5 boys’ schools and 5 girls’ schools), 14 smoked, how many cigarettes did you usually smoke? schools were selected from the eastern part (7 boys’ schools 7. During the past 30 days (one month), did anyone ever and 8 girls’ schools), and 10 schools were selected from the refuse to sell you cigarettes because of your age? western part (5 boys’ schools and 4 girls’ schools). Three 17. Do your parents smoke cigarettes? classes from each school were selected to represent the three 19. Does anyone in your house other than your parents smoke grades, which resulted in a total of 138 classes. Each class cigarettes? was considered a cluster. For practical feasibility, assuming 28. Do you think cigarette smoking is harmful to your health? the principle of normal distribution, a minimum sample size 30. Do any of your closest friends smoke cigarettes? of 30 boys and 30 girls from each school was selected. Ten 32. If one of your best friends offered you a cigarette, would you students from each class were selected randomly by systematic smoke it? sampling technique by using attendance list as sampling frame.
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