Effect of Tobacco Advertisements on Smoking Habits Among Adolescents in Saudi Arabia

Background and Objectives: The rise in adolescent smoking is a public health concern in Saudi Arabia. Several studies have demonstrated that receptivity to tobacco advertising is strongly associated with smoking initiation. Public health practitioners have begun to use counter advertising to prevent the initiation of smoking. This study aimed to assess the effect of antiand pro-smoking advertisements on smoking habits of adolescents in Tabuk, Saudi Arabia. Methods: This was a cross sectional, school-based study conducted in 2005, in Tabuk of Saudi Arabia. A two-stage stratified cluster sampling method was used to select the participants. 1505 public school students in the 7 th through 12th grades were participated in the study, with 98% participation rate. The study tool used was an anonymous, pilot-tested, selfadministered questionnaire, with core items selected from Standardized Global Youth Tobacco survey items. Confidentiality was assured and the study was approved by a research and ethics committee. A Chi-Square analysis was used to assess the associations between exposure to advertisements and smoking habits. Logistic regression was used to identify advertisements that significantly predicted smoking behavior. Results: Of the 1505 students, 43.7% had smoked at least once; of those, 51.1% were current smokers (student who has smoked on one or more days in the 30 days preceding the survey), but only 13.2% smoked daily. Never smokers were exposed to anti-smoking advertisements significantly more often than ever smokers, while ever smokers were exposed to pro-smoking advertisements significantly more often than never smokers. Current smokers watched or read pro-smoking advertisements significantly more frequently than ex smokers (former smokers). Among current smokers, daily smokers watched or read pro-smoking advertisements significantly more frequently than intermittent smokers. Correspondence to: Dr. Abdelshakour M. Abdalla, Email: [email protected] Logistic regression analysis showed that pro-smoking advertisements during sports events, billboards and those showing brand names were significant predictors for the decision to continue smoking among ex smokers and current smokers. Never smokers that were exposed to pro-smoking advertisements were more likely to begin smoking in the future. Anti-smoking advertisements had no significant effects on smoking susceptibility. Conclusions: The smoking prevalence among adolescents was high and associated with watching and reading protobacco advertisements, particularly in movies and sports events. Anti-smoking advertisements require modifications to improve effectiveness.