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J Infect Public Health. 2012 Apr;5(2):159-68. doi: 10.1016/j.jiph.2012.01.002. Epub 2012 Feb 20.

The prevalence and characteristics of water-pipe smoking among high school students in Saudi Arabia.

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College of Medicine, King Saud Bin Abdulaziz, University for Health Sciences, Riyadh, Saudi Arabia.



To identify the prevalence and predictors of the water-pipe (WP) smoking epidemic in the Kingdom of Saudi Arabia (KSA).


A cross-sectional study conducted with 16-18 year-old high school students in Riyadh, Saudi Arabia.


Of the 1272 participants, 414 (33.0%) reported having tried WP smoking. Of this group, 141 (34.1%) were female and 273 (65.9%) were male. Further, 129 (10.2%) students were current WP smokers who had used at least one rock in the past month; 20 were female (1.6%) and 120 were male (8.6%). Regarding age, 276 (68.1%) students who tried WP smoking at least once began when they were over 11 years of age, whereas 129 (31.9%) began WP smoking at or before 11 years of age. Adjusted odds ratios showed that trying WP smoking at least once was associated with smoking after the age of 11 (p=0.021, OR 7.7; CI: 1.4-43.6) and accepting water-pipes from a friend (p=0.024, OR 10.6; CI: 1.4-83.4).


A high prevalence of WP smoking exists among male and female high schools students in Riyadh, KSA. WP smoking was reported to begin in early adulthood.

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