'Smoke-free' policy
The Faculty of Pharmacy has launched the Mobile Tobacco Control Clinic, which is implemented by the Ministry's Anti-Smoking Program in cooperation with The National Tobacco Control Committee of the Ministry of Health, on Wednesday morning, June 15, 1440, in the main lobby in the university city, where the university is keen to combat the phenomenon of smoking, and to set up such a clinic that It is a pioneering step to clarify and deliver the anti-smoking message to university staff (staff and students) at their workplace to make the most of the benefit to university employees.
The clinic was inaugurated by The University's Undersecretary for Educational Affairs, Dr. Mohammed Al-Adib, in the presence of the University's Graduate Undersecretary. And scientific research Dr. Ahmet Al Turki, a number of deans of colleges and agents and assistant director general of affairs Health for Public Health Specialist Mohammed bin Abdul Rahman Al Mana.
Dr. Abdul Majid Al-Qassumi, Dean of the Faculty of Pharmacy, explained that the college will oversee the operation of the clinic And follow up, in cooperation with the Tobacco Control Program of the Ministry of Health, as part of its social responsibility which The university and the college are always keen to give him enough attention.
For his part, Assistant Director General of Health Affairs for Public Health Mohammed Al Mana thanked all my staff The university to host them for the mobile clinic, and facilitate its mission by providing all available possibilities, explaining that the clinic combat Tobacco aims to raise awareness, reduce smoking and help smokers quit , It is useful that the mobile clinic will continue at the university under the supervision of the Faculty of Pharmacy of the University and will provide a number of Of services, including medical consultations, awareness, treatment and follow-up of smoking cessation cases , Hoping that the largest number of university staff and its colleges will benefit from the services Provided by the mobile health clinic.
The university, represented by the Faculty of Pharmacy, continued to organize its health awareness campaign under the slogan "Health care to care", which toured several areas in different parts of the Kingdom, where Dr. Mansour Al-Shiraida, Dean of the Faculty, opened the campaign activities in The Province of Basra, based on the university's keenness to provide its community services to all groups within and outside Qassim region.
The exhibition contained six various sections, including pharmacological awareness, kidney disease awareness, diabetes and blood pressure, as well as a special section to publicize the damage and side effects of antibiotics and medicinal herbs.
The College dedicated a full pavilion in the exhibition to combat smoking for both sexes men and women, with the aim of raising awareness of the harms of smoking and ways of preventing it and how to quit it, through which it provided awareness leaflets and visual presentations to publicize the economic, social and health losses caused by this scourge, which witnessed a remarkable turnout of visitors who expressed their admiration for the contents of the exhibition.
Qassim University has circulated this campaign over the past month in a number of governorates in Qassim and some parts of the Kingdom.
On Sunday, January 30, 1441, the Faculty of Medicine concluded its awareness health campaign "Pulse of Life", which was held in conjunction with World Heart Day and continued for two days in cooperation with the Saudi Heart Association, with the participation of 19 students from the university.
The campaign, which was held at Palm Mall in Buraida, benefited 514 visitors from different groups and ages on several pillars, in which the heart functions were clarified and explained in a simplified manner, in addition to a number of pillars aimed at informing visitors of the most common heart disease, its causes and ways of preventing it, and provided its health services to visitors, which was the measurement of the most important factors causing heart disease: High blood pressure, obesity, diabetes, as well as a corner for children to raise their health awareness.
On September 29th, the world celebrates World Heart Day, which this year is under the theme "Refresh Your Life," focusing on the importance of preventing heart disease, reducing its spread around the world, and enjoying good heart health, with heart disease being the leading cause of death around the world.
World Heart Day also aims to promote a healthy lifestyle and good eating habits, as well as to develop plans that will reduce smoking, reduce the risk of heart disease, reduce the prevalence of high blood pressure globally, as well as raise awareness of the importance of exercise for at least 30 minutes a day, as it reduces the risk of heart disease.
Information and Communication Centre:
For the fifth year in a row, Qassim University participated in the Festival "Rabie Buraida" in 1438 H through an exhibition of 8 student clubs from the university colleges, where it offers more than 40 programs between health, education and legitimacy for festival visitors,
The participants include several events, including the 6 services provided by the Student Club of the Faculty of Medicine, including measuring blood pressure, measuring blood sugar level, measuring height and weight and calculating body mass, education on ophthalmology and thyroid diseases, while the Student Club of the Faculty of Science provides information on detergent chemistry and interactions, and the right ways to deal with it, as well as scientific and educational benefits for visitors, with its chemical and physical experiences.
The Student Club of the Faculty of Pharmacy also participates in 5 awareness programs on chronic diseases, drug safety and the right ways to save medicines and their uses, herbal mixtures and their effects and interaction with medical medications, smoke damage and toxins, in addition to the participation of the student club at the Faculty of Dentistry by offering 5 programs are "Our health in our teeth", "How to take care of oral and dental health", "guidelines for oral and dental health" and "attractive smile".
In turn, the student club at the Faculty of Applied Medical Sciences offers 5 specialized programs including visual acuity, eye safety, detection of refractive errors of the eye, measurement of eye pressure, in addition to conducting ultrasound scans of the kidneys, liver and spleen, determining the blood type, its importance in marriage, pregnancy and childbirth, as well as participating in the student club at the Faculty of Agriculture by offering 5 programs including mummified palm lesions and an integrated solution and estimating the percentage of fat with height measurement and a nursery for ornamental plants and palm fruits.
The Student Club at The Barida Community College also offers 5 diverse programs consisting of training courses for visitors including basic computer and Internet skills, educational applications on smartphones, database systems foundations, human resources management and quality science, while the Student Club of the Faculty of Sharia and Islamic Studies offers two programs dealing with legal and human rights consultations.
For his part, Dr. Fahad bin Ibrahim Al-Dalla, Undersecretary of The Deanship of Student Affairs, President of student clubs at the university, explained that this participation is an extension of the university's previous participations, and in order to activate its community role in which it is to introduce its roles and programs, praising the support received by student clubs by His Excellency Professor Dr. Abdulrahman bin Hamad Al Dawood, Director of the University, and his keenness to show the university's participation in the festival in a distinctive and meaningful way.
The university pavilion, which was implemented by the Deanship of Student Affairs as part of the Spring Buraida Festival 39, received more than 50,000 visitors throughout the festival, where the pavilion provided nearly 120 awareness, educational and health programs, with the participation of 18 student clubs from the colleges of boys and girls, and the services provided to festival visitors included a number of examinations, medical statements, advice and social guidance in addition to a presentation of student products and souvenirs to visitors to the university pavilion.
More than 35 faculty members and university staff, as well as 130 students from 14 student colleges and four girls' colleges, participated in the organization of the 600-square-meter pavilion in Qassim National Park.
The participants presented by the students included several events, including the student club at the Faculty of Medicine, which consisted of measuring blood pressure, blood sugar level, measuring height, weight and body mass calculation, awareness of ophthalmology and thyroid diseases, while the student club at the Faculty of Science provided guidance and information on detergent chemistry and interactions, and the right ways to deal with it, in addition to conducting a number of scientific experiments in chemistry and physics with the aim of educating and educating visitors.
The student club at the Faculty of Pharmacy also participated in awareness programs on chronic diseases, drug safety and the right ways to save medicines and their uses, herbal mixtures and their effects and their interaction with medical drugs, smoking damage and toxins, in addition to the participation of the student club at the Faculty of Dentistry by offering a number of programs including "Our health in our teeth", where visitors were educated how to take care of the health of the mouth and teeth, and provide guidance to maintain it and an attractive smile.
In turn, the student club at the Faculty of Applied Medical Sciences provided programs specialized in measuring visual acuity, eye safety, detection of refractive errors of the eye, measurement of eye pressure, in addition to conducting ultrasound scans of the kidneys, liver and spleen, identifying blood type, its importance in marriage, pregnancy and childbirth, as well as the presentation of the college products of soap, perfumes and others, and participated the student club in the Faculty of Agriculture by providing programs that included mummified palm lesions and an integrated solution and estimating the percentage of fat with height measurement, as well as nursery About ornamental plants and palm fruits.
The student club at the Community College also offered a variety of programs that included training courses for visitors in basic skills of computers and the Internet, educational applications on smartphones, the foundations of database systems, human resources management and quality science, while the student club at the Faculty of Sharia and Islamic Studies provided two programs on legal and human rights consultations.
For his part, Dr. Ali Al-Aqal, Dean of The Dean of Student Affairs, explained that the university's participation in the exhibition comes as an extension of the social work provided by the university throughout the year, and within the framework of the keenness of its management and its employees to provide various services to the community, whether educational or awareness and medical and reach different segments of society through tourism activities, pointing to the diversity of services provided in the university pavilion participating in the spring of Buraida this year due to the participation of colleges with various specialties of interest to all festival visitors, praising support Received by His Excellency Dr. Abdulrahman bin Hamad Al Dawood, Director of the University, and his keenness to show the university's participation in the festival in a distinctive and meaningful way for all visitors.
Over the past six years, the University has participated continuously in the spring buraida festival, with a special pavilion through which it has provided many college activities in various fields, as well as awareness and educational exhibitions, recreational and service events, cultural and religious competitions, and souvenirs for festival visitors.
Tobacco use is declining in the developed but increasing in some developing countries. It is estimated that about 80% of the world’s smokers are from developing countries (Gajalakshmi, Jha, Ranson, & Nguyen, 2000). Smoking increases the burden of poverty and illnesses already dominated in this part of the world.
Unfortunately, there is still very low awareness about tobacco-related health risks in many low-income communities due to illiteracy, weak tobacco control measures, and the misleading activities of the international tobacco industry that is now focusing more of its activity on developing countries.
In this article, we report tobacco control initiatives taken by the authority in Qassim University, Saudi Arabia during 2011–2012, including the establishment of a smoking cessation clinic. We hope that reporting these initiatives will encourage other academic institutions to adopt similar policies and regulations.
Although use of tobacco has been prohibited and considered as a sin by many of the Islamic scholars in the country, it is very common to observe tobacco use in Saudi Arabia, and its use may be increasing. Unfortunately, there is no accurate and up-to-date nationwide estimation of tobacco use.
According to Mackay and associates (2006), the prevalence of tobacco smoking among males in Saudi Arabia is less than 20%. However, this does not include the use of shisha (or water pipes), which is very common in the middle east. Other small-scale and regional surveys conducted in Saudi Arabia report comparable rates (Al-Mohamed and Amin, 2010; Jarallah, Al-Rubeaan, Al-Nuaim, Al-Ruhaily, & Kalantan, 1999; Mandil et al., 2011).
By contrast, Saudi Arabia was ranked 8th in the world in terms of cigarette consumption (Al-Doghether, 2001), suggesting use may be higher. The Saudi government spends around $2.5 billion per year to curb smoking-related diseases (Haseebullah and Almotairi, 2012).
A comprehensive approach to tobacco control is necessary to make progress as individual interventions are insufficient alone. According to Al-Lehiany and Stanley (2009), the establishment of recognized tobacco control initiatives began in Saudi Arabia after 2001. For example, the Saudi government launched its first antismoking campaign in 2003 (Haseebullah and Almotairi, 2012).
Qassim University is a public university that is located in Al-Qassim region to the north of Riyadh, the capital city of Saudi Arabia. The Al-Qassim population is estimated to be around 1 million with the majority staying in Buraidah (about 49%) and Unaizah provinces. The university community consists of about 40,000 students and around 4,000 academic and administrative staff.
In Qassim University, some efforts have been made to help control growing tobacco use, particularly among students. Since November 2011, smoking was prohibited inside Qassim University campuses. Punishments have been announced that can rise as high as expulsion. A committee, setup under the students’ affairs division, took responsibility for disseminating information and awareness about the negative impacts of tobacco use using posters, brochures, and other printed materials. Display screens situated at the main gates and on the entrances of various colleges are used to disseminate antitobacco messages.
The largest tobacco control initiative in the university was the establishment of a smoking cessation clinic that is affiliated to the college of medicine. The clinic was launched in October 2012 and is equipped with facilities such as a large screen for displaying videos about tobacco hazards, models that depict tobacco-related diseases on various human organs, and instruments for assessing lung capacity, carbon monoxide, and oxygen levels.
Pharmacotherapeutic treatments provided to patients willing to quit smoking include nicotine replacement therapy in the form of lozenges and patches. The clinic is managed by a pharmacist, assisted by a medical doctor and a nurse for the purpose of clinical assessment. The current working plan of the smoking cessation clinic includes follow up of registered patients and provision of prizes to quitters to motivate smokers to participate. There is a plan to perform some research activities alongside the smoking cessation assistance service.
In Saudi Arabia, it is relatively easy to establish a smoking cessation clinic or a tobacco control center that is equipped with all required devices and pharmacotherapies. Thirty-three smoking cessation clinics across Saudi Arabia have been established over the last 20 years (Bassiony, 2009). Most of the smoking cessation clinics are funded by government (Ministry of Health, Ministry of Social Affairs & some universities). However, some clinics are run by national NGOs, and some are business- oriented private services. Having access to them will lead to less worry about the affordability of cessation medication to the smokers particularly among government employees as government covers such treatment expenses.
Records from smoking cessation clinics show promising results. According to Salih and Farghaly (1996), a smoking cessation clinic in one of the main public hospitals in Buraidah achieved 38.3% 6-month successful quit rate. However, another record that reported on the success rates among smokers attending smoking cessation clinics in Saudi Arabia mentioned only 13% (Bassiony, 2009).
The most important challenges that are faced by smoking cessation clinics in Saudi Arabia are finding easily accessible locations, marketing their services and increasing awareness of their existence among the community, and encouraging smokers to participate in their programs. Previous reports do not report on success in encouraging participation. Bassiony (2009) mentioned that the use of these clinics is still limited.
There is a need to improve the clinics’ outreach. Improving the quality of the services offered by those clinics is another priority. Provision of smoking cessation services in primary health care centers has been inconsistent in terms of existence and quality of counseling provided and is often characterized by the use of different and sometimes ineffective methods for smoking cessation (Al-Doghether, 2001). It is advisable to follow an evidence-based approach in the provision of the smoking cessation service. This requires establishing national smoking cessation guidelines and adopting only evidence-based smoking cessation treatments (Al-Doghether, 2001).
In a country like Saudi Arabia, it is feasible to set up smoking cessation services. However, there is a need to improve such services and to set up a marketing strategy to raise awareness among community leaders, policy makers, health care providers, and the public about their existence. There is also a need to evaluate the services of smoking cessation clinics currently existing and to support the service by strengthening other tobacco control measures and policies.
Study Design and Data Sources
A cross-sectional cohort study was conducted to explore factors affecting beliefs about hookah smoking cessation interventions using a paper-based survey. Data were collected between November 2018 and April 2019 at a higher education institute in Qassim province.
Participants
The research was conducted in colleges that agreed to participate, including health sciences, humanities, and social science colleges. All colleges in the Saudi educational system admit students after they have completed their secondary school degree (18 years and above).
Each of the participating teaching faculties were asked to distribute the survey and consent forms to students and to allot 20 minutes for students to complete the survey. Participation was anonymous and voluntary. Each student was asked to drop the completed survey in a box; they were allowed to stop at any time without providing a reason.
Results
Out of the 1158 surveys distributed, 958 were received, for a response rate of 82.7%. The mean age of the participants was 22.1 ± 2.5 years. About 20% of the respondents reported that they had smoked a hookah within the past 30 days. The average age of the participants when they starting hookah smoking was 16.9 ± 4.4 years.
Descriptive statistics were calculated for the smoking cessation medication cohort and the behavioral intervention cohort. Participants were grouped into two age categories (Tables 1 and 2). In both cohorts, around 78% of the respondents were in the 18–23 age group. Moreover, ≈95%, of the sample were unmarried, ≈96% had an income of more than US$264/month, ≈95% had good to excellent academic performance, and ≈80% were not hookah smokers. Furthermore, ≈70% of the respondents thought that hookah smoking was less harmful than cigarette smoking. When asked to assess the social acceptability of hookah smoking, ≈46% of the students answered “none” suggesting that hookah smoking is not socially acceptable.
Table 1 Demographic Characteristics and Bivariate Analysis of Factors Associated with Beliefs Among College Students in Saudi Arabia About Using Cessation Medications in the Qassim Region.
Table 2 Demographic Characteristics and Bivariate Analysis of Factors Associated with Beliefs Among College Students in Saudi Arabia About Using Behavioral Interventions in the Qassim Region.
The results of the bivariate analyses of the demographic covariates (eg age, gender, income) as well as the other smoking-related variables are shown in Tables 1 and 2. Table 1 shows the association between these variables and participants’ belief in the effectiveness of the medication intervention for smoking cessation. The demographic covariates did not show any significant association with their beliefs regarding the medication intervention. A significantly greater number of participants who believed in the effectiveness of the medication intervention did not smoke a hookah (p <0.001). However, the belief in the harmful effects of smoking a hookah was significant, with most of the respondents who believed in the effectiveness of the smoking cessation medication intervention indicating that they believe that hookah smoking was less harmful than cigarette smoking (p < 0.001).
Table 2 shows the bivariate analysis results based on participants’ beliefs in the effectiveness of behavioral interventions. There was a significantly greater number of students in the 18–23 age group (p = 0.007) viewing the behavioral intervention favorably. While gender did not have a significant association with beliefs regarding medication cessation, more males believed in the effectiveness of the behavioral interventions (p = 0.022). There was a significantly greater number of hookah nonsmokers who believed in the effectiveness of behavioral interventions (p = 0.005). Moreover, students who believe in the effects of a behavioral intervention also tended to think of hookah smoking as less harmful than cigarettes (p < 0.001).
Two multiple logistic regression analyses were conducted: one for smoking cessation medication (Table 3) and one for behavioral intervention (Table 4). In Table 3, the total sample size excluding missing values was 878 students. Smoking a hookah within the past 30 days was associated with less likelihood of believing in the effectiveness of smoking cessation medication interventions (marginal effect = -7.9%; 95% CI, −15.6 to −0.3%). In addition, respondents who thought that hookahs are the same as or less harmful than cigarettes were less likely to believe in the effects of medication interventions compared to the reference group respondents (more harmful than cigarettes), (marginal effect = -25.6%; 95% CI, −34.7% to −16.6%) and (marginal effect = -12.3%; 95% CI, −22.3% to −2.3%), respectively. The Hosmer−Lemeshow goodness of fit test was conducted to identify the model fit and it indicated a good fit for the model (p = 0.370).
Table 3 Multiple Logistic Regression Results of Factors Associated with Beliefs Among College Students in Saudi Arabia About Using Cessation Medications in the Qassim Region (n=878).
Table 4 Multiple Logistic Regression Results of Factors Associated with Beliefs Among College Students in Saudi Arabia About Using Behavioral Interventions in the Qassim Region (N=885).
Table 4 shows the results of the multiple logistic regression on the factors associated with beliefs in the behavioral intervention. This analysis included 885 participants. Students aged >23 years were 10.4% more likely to believe in the effectiveness of a behavioral intervention (marginal effect = 10.4%; 95% CI, 2.3%–18.6%). Smoking a hookah within the past 30 days was associated with less likelihood of believing in behavioral interventions (marginal effect = -8.1%; 95% CI, −16.2% to −0.1%). Furthermore, students who thought that hookahs were less harmful than cigarettes were less likely to believe in the positive effects of behavioral interventions (marginal effect = −15.9%; 95% CI, −25.9% to −5.9%). Regarding model fit, the Hosmer−Lemeshow goodness of fit test showed the model fit the data well (p = 0.274).
A third multiple logistic regression was conducted for the 70 participants who indicated that they were hookah smokers to explore factors associated with their beliefs regarding medication interventions (Table 5). Those with a willingness to quit smoking a hookah were more likely to believe in smoking cessation medications (marginal effect = 42.9%; 95% CI, 28.2%–57.6%). The Hosmer–Lemeshow goodness of fit test for this model showed the model fit the data well (p = 0.1210).
Table 5 Multiple Logistic Regression Results of Factors Associated with Beliefs among Smoking College Students in Saudi Arabia Regarding the Use of Cessation Medications in the Qassim Region (n=70).
Table 6 shows the last multiple logistic regression performed for factors associated with beliefs among smokers about behavioral interventions. When the same independent variable was tested on the sample sub-population (hookah smokers) to evaluate its association with the behavioral intervention, a significant positive association was found. Students who were more willing to quit smoking a hookah were more likely to believe in a behavioral intervention (marginal effect = 28.6%; 95% CI, 9.3%–48.0%). The Hosmer–Lemeshow goodness of fit test reflected that this model fit the data well (p = 0.1142).
Table 6 Multiple Logistic Regression Results of Factors Associated with Beliefs Among College Smokers Students in Saudi Arabia Using Behavioral Interventions in the Qassim Region (n=78).
Objective
The main objective of this study was to investigate the prevalence and beliefs of water pipe & cigarette smoking among Qassim University male students.
Methodology
A cross-sectional survey was conducted among the students of Literature Colleges, Health Colleges of Qassim University and a self-administered, anonymous, pre-structured, designed proforma was distributed among randomly selected group of 500 male university students during January 2011.
The questionnaire was designed to ask specific questions that are related to cigarette smoking and water pipe smoking in general and their belief regarding smoking. Statistical analysis was done using SPSS software.
Results
The total prevalence rate of waterpipe smoking was found to be 40% and Cigarette smoking was 41%. The major prevalence was found among the students of Health College (50%) then Science College (38%) and Literature College (12%). Cigarette smoking, smoking among relatives and friends has significant association (P<0.05) with prevalence of waterpipe among university students, while residence, income and marital status do not have any significant effect on water pipe smoking.
Conclusions
Approximately more than one-third of the students currently smoke waterpipe. Smoking of both cigarette and waterpipe was frequently found and it is precipitated with the same habits in family and friends.
Background:
The popularity of e-cigarettes is increasing rapidly worldwide and advertisements for such products are becoming ubiquitous in the media. Health concerns and smoking cessation are the most commonly reported reasons for traditional tobacco smokers to shift to e-cigarettes. As a result, the global market for e-cigarettes is on the rise. However, they are still a potential cause for many diseases.
Methods:
This is a cross-sectional study carried out at Qassim University in Buraydah, Saudi Arabia. A prevalidated questionnaire was distributed to medical students in April 2018 to evaluate the experience, knowledge, and awareness of e-cigarettes among the participants.
Results:
About one in ten students confirmed having smoked an e-cigarette. There was no significant relationship between e-cigarette users and demographic factors, such as gender, academic level, or age.
However, the study showed a significant association between e-cigarette smoking and having an e-cigarette smoker among family members or friends. Most students 71.9% were not sure whether e-cigarettes were approved by the Food and Drug Administration (FDA) for smoking cessation. Only 23.3% of those surveyed believed that e-cigarettes can help in smoking cessation, whereas only 11% said that they would recommend it for a patient. On the contrary, 49.6% agreed that e-cigarettes are addictive. In response to another question, 92% reported receiving no education in medical school about e-cigarettes.
Conclusion:
Our study showed that medical students lacked knowledge about e-cigarettes. Therefore, more studies are needed to raise awareness about e-cigarettes, especially since the habit of using e-cigarettes is invading our society.
