Self-efficacy and smoking behavior among high school students in Madinah city, Saudi Arabia

Background: Smoking behavior among adolescents is found to be influenced by many factors. Self-efficacy factors, however, have been of little concern in the Saudi literature. Objectives: to examine the association of smoking behavior with self-efficacy among secondary school students in Madinah City, Saudi Arabia. Methods: A secondary school-based cross-sectional study was conducted in Madinah City, Saudi Arabia during the study year 2019-2020. A cluster multistage random sampling technique was taken from 10 (5 male and 5 female) secondary schools. Smoking related data were collected using a predesigned structured self-administered questionnaire. Self-efficacy data were studied as a dichotomous variable according to its median distribution. The prevalence of current smokers was estimated and its association with self-efficacy levels was examined using logistic regression analysis. Results: The response rate was 91.6% (641/700). The prevalence of current smokers was 26.4% (95%CI = 23–30%). The prevalence showed statistically significant differences among adolescents by their sex, mother’s education, and parents’ and friends’ smoking. The mean self-efficacy was slightly lower in current smokers 27.5 (5.9) vs. 27.8 (5.6). The likelihood to quit smoking was significantly higher among male smokers (adjusted OR = 3.5; 95%CI = 1.23–9.90) with high self-efficacy