Prevalence and Determinants of Waterpipe Tobacco Use among Adolescents in Oman

Objective: To assess the prevalence and determinants of waterpipe use among school-going adolescents in Oman.Methods: A cross-sectional, school-based study was conducted in 2003 involving 9 regions of Oman, as part of the Global YouthTobacco Survey. Participants were requested to complete an anonymous questionnaire containing demographic characteristics, currentand previous use of waterpipe tobacco, attitudes towards cigarette smoking, parents¡¦ and friends¡¦ cigarette smoking habits. Proportionswere used to calculate prevalence rates and logistic regression analysis to obtain odds ratio (OR) and 95% confidence interval(CI). Results: ÆÌ,962 students participated of whom ÆÌ,005 (5ÆÌ.2%) were males. Eighty-eight percent were between ÆÌ3 and ÆÌ6 years ofage. Five hundred and twenty-two (26.6%) reported ever smoking waterpipe tobacco while ÆÌ89 (9.6%) were current users. Amongmales, ÆÌ55 (ÆÌ5.5%) were current users while among females only 24 (2.6%) smoked currently. Study participants were more likely touse waterpipe if they had a parent or friend who smoked cigarettes. Adolescents were, however, less likely to use waterpipe tobacco ifthey believed that cigarette smoking was harmful to health. Students who were receiving 500 Baisas (US$ ÆÌ.3) or more per day pocketmoney were more likely to use waterpipe tobacco compared to those receiving less (OR 3.3, 95% CI 2.3 to 4.6). In multivariate analysis,the OR for males being a smoker of waterpipe tobacco compared to females was 4.46 (95% CI, 2.38 to 8.35); while the OR for most orall friends smoking cigarettes compared to non-smoking was OR 5.65 (95% CI 2.87 to ÆÌÆÌ.ÆÌ3). Study participants who perceived smokingas harmful to health were less likely to use waterpipe tobacco compared to those who did not believe smoking was harmful (OR0.3ÆÌ, 95% CI 0.29 to 0.92) and those receiving 500 Baisas or more (OR 2.2, 95% CI ÆÌ.5 to 3.2). Conclusion: Waterpipe smoking amongOmani adolescents is an emerging public health concern. Efforts to prevent adolescent smoking should be designed with knowledgeof associated factors of such behaviour and should include all forms of tobacco.