Factors associated with tobacco smoking among Saudi college students: A systematic review

INTRODUCTION There has been an increase in tobacco smoking among Saudi college students in recent years. However, no study has examined, with a systematic approach, the extent to which specific factors are associated with tobacco smoking among this population. METHODS PubMed, ProQuest, CINAHL, and Web of Science were utilized to retrieve studies addressing risk factors associated with tobacco smoking among Saudi college students between 2010 and 2019. After confirming their eligibility criteria, studies were imported to the NVivo software for data collection and synthesis. All included articles were critically appraised, based on a modified STROBE. RESULTS Twenty-one out of 300 studies met the eligibility requirements for inclusion. Riyadh was the location, health-related science was the field of study, and male the gender of the population of most of the included studies. Only one study used a longitudinal design based on a theoretical framework, the rest were cross-sectional and lacked theoretical utilization. Four individual and two social factors were established to have a significant relationship with tobacco smoking behavior among college students in four or more studies. Environmental factors were found to be associated with a change in smoking behavior among Saudi college students based on two studies. CONCLUSIONS There is a dearth of research in utilizing theoretical frameworks to guide the research in order to propose an intervention program among Saudi college students. Future research should aim to recruit participants from different institutions in the Kingdom of Saudi Arabia (KSA), apply other methodological approaches, test other measurements of tobacco smoking, and utilize a theoretical framework.