Abstract
Initiation of smoking behavior during adolescence is associated with negative health outcomes. Understanding initiation of smoking behavior in adolescents in relation to other behavioral, health, and environmental factors is essential for effective behavioral modification. The aim of this study was to describe tobacco use behaviors among adolescents in Riyadh, Saudi Arabia, and related demographic and social factors. A total of 1430 students aged 14-19 from high schools across the city of Riyadh participated in the study. A comprehensive adolescent health survey was administered to students in high school classrooms across Riyadh. Data were analyzed primarily via contingency tables with χ2-tests. One in five students reported having ever smoked cigarettes, with a significantly higher proportion of boys than girls reporting tobacco use. Students who smoked had significantly lower school connectedness compared with those who never smoked. Tobacco use by family members was common, and students with at least one family member who smoked were significantly more likely to use tobacco themselves. Improving school connectedness among students by fostering supportive and safe school environments could be a potential strategy for reducing adolescent smoking. Reducing smoking in the general population and educating families about being better role models for youth are also critical.