Background: Although the prevalence of smoking has been decreasing in the developed countries in recent years, the less developed countries, such as Iraq, are facing an impact from smoking prevalence rise. Objective: The study objective was to assess the prevalence of smoking and its correlates among secondary school students. Materials and Methods: A descriptive cross-sectional epidemiological study was conducted on the secondary school students 4th, 5th, and 6th for males and females who were indiscriminately selected from 15 secondary schools located in Al-Hilla city\Babylon Province\Iraq during the period from March 7 to April 30, 2018. A questionnaire adapted from global school-based student health survey (2013) was used to collect data. Results: Of 860 students, only 810 responded and completed the questionnaire (response rate 94.2%). The overall prevalence of smoking was 32.0%, and the majority of smokers were male. The dominant type of tobacco smoking in this study appeared to be a hookah in about two-thirds (one-third exclusive hookah smoking and one-third mixed hookah and cigarette smoking), and multiple reasons have been found to impulse the student to smoking and that the friend was the first tobacco source. A significant association has been found between tobacco smoking and gender, age, grade, income, marital status, having alive parents, abuse, early age work, school performance, having a family member with medical diseases, family relationship, and sleeping difficulties (P
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