Date of Award

Spring 5-2023

Document Type


Degree Name

Doctor of Philosophy (PhD)


Heath Services Research

Committee Director

Praveen Durgampudi

Committee Member

Abdullah Al-Taiar

Committee Member

M’Hammed Abdous


This dissertation intended to learn more about Saudi college students' behavior in relation to the use of tobacco smoking. Multiple interrelated projects have been carried out in order to achieve this ambitious goal. The goal of the first study was to evaluate the scope of the existing smoking issue as indicated by research, by systematically estimating the prevalence of tobacco use among higher education students in Saudi Arabia. The second study aimed to systematically analyze and integrate the existing information on the determinants of smoking among Saudi college students. The last project aimed to develop a psychometric instrument to evaluate Saudi students' beliefs about cigarette smoking based on a theoretical model.

The meta-analysis (Project 1) estimated that the 17% of Saudi students were current smokers. In order to obtain a reliable prevalence rate over time, the study suggested implementing a nationwide surveillance system that measures and monitors Saudi students’ smoking behaviors. The second systematic review (Project 2) determined that individual level factors were the most studied. Another finding was the limited usage of theoretical frameworks. The study advocated for the use of rigorous research methodologies and for the use of multi-level frameworks. The final project (3) was intended to generate and to validate a psychometric property to evaluate students’ beliefs about cigarette smoking, using an individual level framework. The Arabic Health Belief Model questionnaire demonstrated its sound validity and reliability. Future research is encouraged, in order to expand knowledge about smoking behaviors among college students in Saudi Arabia.


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