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A total of 2024 students were invited to participate and 1,962 of them completed the survey. The school response rate was 100%, the student response rate was 96.9% and the overall response rate was 96.9%. Table below illustrates the study subjects by school grade and gender. (44students have no response to this question)
Table 3: Number of respondents in the Oman GYTS, 2003.
| Grade | Boys (%) | Girls (%) | Total |
|---|---|---|---|
| Eighth | 264 (39.1) | 412 (60.9) | 676 |
| Ninth | 291 (59.4) | 199 (40.6) | 490 |
| Tenth | 450 (59.8) | 302 (40.2) | 752 |
| Total | 1005 | 913 | 1918 |
Table 4: Percent of students who use tobacco, Oman GYTS, 2003.
| Category | Ever Smoked Cigarettes, Even One or Two Puffs | Current Users | Never Smokers Susceptible to Initiating Smoking | ||
|---|---|---|---|---|---|
| Any tobacco product | Cigarettes | Other Tobacco Products | |||
| Total | 19.5 (±3.9) |
18.2 (±3.9) |
9.1 (±3.4) |
12.8 (±2.5) |
14.3 (±2.8) |
| Boys | 31.4 (±5.9) |
27.3 (±6.4) |
16.2 (±6.1) |
17.8 (±4.0) |
19.1 (±3.9) |
| Girls | 6.8 (±2.8) |
8.9 (±1.8) |
1.8 (±1.1) |
7.7 (±1.5) |
10.6 (±3.7) |
Any Tobacco product includes both cigarettes and other tobacco product.
One in five (19.5%) of all students have ever smoked cigarettes (table 3) with ever smoking five times as high for boys (31.4%) compared to girls (6.8%). Approximately one in five students currently use any tobacco products. Over 9% of students currently smoke cigarettes while 12.8% currently use other tobacco products. Current use of any tobacco product, cigarette smoke and use of other tobacco product were significantly higher for boys than girls. Girls who currently use other tobacco products were four times higher than those who are current user of cigarettes.
Over 14% of all students indicate that they were likely to initiate smoking during next year with significant gender differences (twice as high as for boys (19.1%) compared to girls 10.6%)).
Table 5: Percent of students who use Shishah, Oman GYTS, 2003.
| Category | Ever used Shishah | current use Shishah |
|---|---|---|
| Total | 27.3 (±3.3) |
9.9 (±2.6) |
| Boys | 37.2 (±3.7) |
16.6 (± 3.6) |
| Girls | 17.2 (± 2.7) |
2.6 (± 1.2) |
Nearly one third of all students (27.3%) have ever used Shishah, which was twice as high for boys than girls. One in ten of all students (9.9%) currently use Shishah. The figure was five times as high for boys than girls.
Table 6: Percent of students who use chewing tobacco, Oman GYTS, 2003.
| Category | Ever used chewing tobacco | Currently using chewing tobacco |
|---|---|---|
| Total | 15.1 (±2.8) |
9.1 (± 2.7) |
| Boys | 20.3 (± 4.3) |
15.3 (± 3.7) |
| Girls | 10.2 (± 2.4) |
2.7 (± 1.4) |
15.1% of all students have ever used chewing tobacco with twice as high for boys than girls. One in ten of all students (9.1%) currently use chewing tobacco with five times as high for boys than girls.
Table 7: School Curriculum, Oman GYTS, 2003.
| Category | Percent taught dangers of smoking | Percent discussed reasons why people in their age smoke |
|---|---|---|
| Total | 46.2 (±5.6) |
33.9 (±5.0) |
| Boys | 44.8 (±5.1) |
35.5 (±4.9) |
| Girls | 47.0 (±9.6) |
31.5 (±8.8) |
Less than half of all students were taught in schools during the past year about the dangers of smoking (46.2%) and one third of students had discussed during the past year reasons why people in their age smoke (33.9%). There was no significant difference by gender.
Table 8: Desire to quit smoking, Oman GYTS, 2003.
| Current Smokers | ||
|---|---|---|
| Category | Percent desire to stop | Percent tried to stop this year |
| Total | 77.7 (±11.8) |
67.3 (±10.4) |
| Boys | 79.3 (±11.7) |
68.7 (±11.9) |
| Girls | 61.6 (±34.7)* |
54.7 (±36.9)* |
*The number of respondents (n) in this cell is less than 35
Eight in ten students who currently smoke cigarettes stated that they currently desire to stop smoking (77.7%). Seven in ten students tried to stop smoking during the past year but failed (67.3%)
Table 9: Environmental Tobacco Smoke, Oman GYTS, 2003.
| Exposed to smoke from others in their home | Exposed to smoke from others in public places | Percent think smoking should be banned from public places | |||
|---|---|---|---|---|---|
| Category | NS | CS | NS | CS | |
| Total | 16.8 (±3.8 |
55.0 (±16.9) |
27.4 (±3.4) |
81.1 (±10.0) |
86.0 (±2) |
| Boys | 15.9 (±4.4) |
53.5 (±18.1) |
32.1 (±5.0) |
80.5 (±11.1) |
82.7 (±2.9) |
| Girls | 17.7 (±6.0) |
88.6 (±14.9) |
23.7 (±5.6) |
87.6 (±20.1) |
89.3 (±2.9) |
| NS = Never Smolers CS = Current Smokers | |||||
The exposure to environmental tobacco smoke for places both inside and outside of the home was three times higher for current cigarette smokers compared to those who have never smoked cigarettes.
Approximately nine in ten (86.0%) students think that smoking should be banned in public places.
Tableb 10: Knowledge and Attitudes, Oman GYTS, 2003.
| Category | Think boys who smoke have more friends | Think girls who smoke have more friends | Think smoking makes boys look more attractive | Think smoking makes girls look more attractive | ||||
|---|---|---|---|---|---|---|---|---|
| NS | CS | NS | CS | NS | CS | NS | CS | |
| Total | 32.2 (±2.3) |
49.6 (±18.4) |
16.9 (±2.1) |
14.6 (±8.2) |
22.1 (±2.7) |
43.8 (±19.3) |
15.9 (±2.8) |
20.1 (±8.0) |
| Boys | 31.9 (±3.8) |
52.6 (±19.8) |
17.4 (±3.1) |
14.8 (±8.9) |
22.5 (±3.2) |
44.9 (±21.8) |
20.5 (±3.3) |
29.6 (±29.2) |
| Girls | 32.1 (±2.8) |
29.4 (±30.9) |
16.0 (±2.7) |
5.1 (±9.3) |
21.7 (±4.5) |
37.6 (±15.7) |
21.9 (±8.3) |
29.6 (±29.2) |
| NS = Never Smolers CS = Current Smokers | ||||||||
Approximately one third of never smokers (32.2%) think that boys who smoke have more friends while one fifth of them (22.1%) think that smoking makes boys look more attractive with no significant difference between boys and girls. Half of current smokers (49.6%) think that boys who smoke have more friends and (43.8%) think that smoking makes boys look more attractive with no significant difference by gender.
One in five of never smokers think that girls who smoke have more friends and look more attractive (16.9% and 15.9% respectively) with no significant difference between males and females. One in five of current smokers think that girls who smoke have more friends and look more attractive (14.6% and 20.1% respectively) with no significant difference between males and females.
Table 11: Attitude towards smoking from others and Shishah, Oman GYTS, 2003.
| Category | Definitely think smoke from others is harmful to them | Think that Shisha is less harmful than cigarette | ||
|---|---|---|---|---|
| Never Smokers | Current Smokers | Never used Shishah | Current use Shishah | |
| Total | 54.7 (± 3.5) |
35.5 (±14.6) |
34 (± 4.9) |
43.6 (± 7.2) |
| Boys | 49.6 (±4.7) |
34.6 (±16.0) |
32.8 (± 7) |
42.4 (± 9.2) |
| Girls | 58.2 (±4.5) |
41.0 (±37.7)* |
35.6 (±7.2) |
47 (±9.0) |
*The number of respondents (n) in this cell is less than 35
Nearly four in ten of current smokers (35.5%) and more than half of non- smokers (54.7%) definitely think that smoke from others is harmful to them with no significant difference between boys and girls. Nearly four in ten of current use of Shishah (43.6%) and one third of never use Shishah (34%) think that Shishah is less harmful than cigarettes with no significant difference between boys and girls.
Table 12: Media and Advertising, Oman GYTS, 2003.
| Category | Percent Saw Anti-Smoking Media Messages | Percent Saw Pro-Tobacco Messages in Newspapers and Magazines | Percent Who Had Object With a Cigarette Brand Logo On It | Percent Offered Free Cigarettes by a Tobacco Company Representative | |||
|---|---|---|---|---|---|---|---|
| NS | CS | NS | CS | NS | CS | ||
| Total | 74.1 (±1.9) |
63.5 (±3.9) |
76.3 (±10.2) |
10.8 (±2.1) |
14.7 (±7.6) |
11.8 (±1.9) |
14.3 (±7.2) |
| Boys | 75.3 (±2.4) |
63.6 (±5.9) |
77.7 (±11.1) |
14.0 (±4.6) |
11.8 (±7.4) |
13.5 (±2.4) |
12.2 (±6.9) |
| Girls | 72.7 (±3.1) |
63.2 (±6.8) |
73.8 (±14.4) |
8.1 (±1.3) |
37.6 (±15.7) |
10.8 (±12.4) |
27.3 (±18.3) |
| NS = Never Smolers CS = Current Smokers | |||||||
Three-fourth of students (74.1%) saw anti-smoking media messages in the past 30 days. Six in ten of never smokers (63.5%) and eight in ten current smokers (76.3%) saw pro-tobacco messages in newspapers and magazines during the past 30 days. One in ten of both never smokers (10.8%) and current smokers (14.7%) had an object with a cigarette brand logo on it with significant between male and female current smokers. One in ten of both never smokers (11.8%) and current smokers (14.3%) were offered free cigarettes by tobacco company representative.
Table 13: Access and Availability, Oman GYTS, 2003.
| Category | Percent Current Smokers who Usually Smoke at Home | Percent Current Smokers who Purchased Cigarettes in a Store | Percent Current Smokers Who Bought Cigarettes in a Store Who Were Not Refused Because of Their Age |
|---|---|---|---|
| Total | 12.3 (±7.2) |
42.6 (±18.0) |
85.6 (±13.3) |
| Boys | 8.4 (±7.0) |
46.2 (±19.1) |
84.8 (±14.3) |
| Girls | 53.2 (±25.3) |
4.6 (±9.0) |
100.0 (±0.0) * |
*The number of respondents (n) in this cell is less than 35
One in ten of current smokers (12.3%) usually smoke at home. Six times as many female current smokers smoke at home compared to male current smokers (53.2% and 8.4% respectively). Less than half of current smokers (42.6%) purchase cigarettes in a store. Nine times as many male current smokers purchase cigarettes in a store. Nine in ten of current smokers (85.6%) had not been refused purchase because of their age.
The Global Youth Tobacco Survey in Oman is a first national school–based survey, which was conducted among students in grades 8–10. Many studies were conducted to measure the prevalence of smoking among school children but the GYTS is considered the first study in Oman concerning issues about other tobacco products, school curriculum and the effect of media. As it used the same standardized core questionnaire and protocol as many neighboring countries like Kuwait, the United Arab Emirates and the kingdom of Saudi Arabia, it enables us for the first time to make cross country comparison in prevalence and other related issue concerning tobacco use.
The Oman GYTS shows a high prevalence of tobacco use among school students. Nearly one-fifth of students currently use any tobacco products with 9.1% currently smoke cigarettes and 12.8% currently use other tobacco products such as water-pipes (Shishah) and smokeless chewing tobacco. These prevalence rates are similar to those published in the United Arab Emirates (UAE) and Kuwait.
As expected boys were significantly higher than girls to have ever tried smoking cigarettes. However, as shown by the recent media campaigns, the tobacco companies make relentless efforts to conquer this segment of the youth of the Omani society.
The survey data showed the fact that, for this segment of the population, water-pipe (Shisha) consumption is as much prevalent as cigarettes.. This was to be expected as recently municipal rules to grant permission to Shishah cafes were relaxed and consequently such cafes flourished rapidly not only in the capital Muscat but also to other regions where in the past tough regulation were enforced. Surprisingly enough is the fact that girls who currently use other tobacco product were four times higher than those who smoke cigarettes illustrating the need to encompass all types of tobacco use when developing intervention strategies.
Over 14% of all students indicated that they were likely to initiate smoking during the next year with significant difference, twice as high for boys compared to girls. This figure is alarming and need more efforts to establish intervention programs to protect them. It is not clear as to why these students felt particularly vulnerable to tobacco use.
Most international studies show a strong desire by adult smoker to quit the habit. This appears to be the case also for young people the vast majority of whom were current smokers (77.7%) stated that they currently desire to stop smoking. However, seven in ten students tried to stop smoking during the past year but failed.
During the past two decades, research conducted world wild showed that tobacco consumption in any form and exposure to environmental tobacco smoke can cause numerous diseases and disability. The GYTS in Oman showed that the exposure of young people to environmental tobacco smoke for places both inside and outside of the home is high with exposure being three times more in current smokers than the never smokers.
However the data revealed a positive students’ attitude that must be appreciated. Approximately nine in ten students think that smoking should be banned in public places. Currently there are no comprehensive national legislations to protect the general public form exposure to tobacco smoke. Accordingly administrators of the public facilities can choose when, where and if they there is a need to ban smoking in public places like restaurants and cafes or recreation facilities and children play areas. Unfortunately, often is the case that they opt not to.
Health education programs should be strengthened to alert the current smokers about the harmful effect of smoking on themselves and others. However without strong legislations in place it is unlikely that such efforts can lead to change in individual behavior.
An important implication of the data is exemplified by the fact that more current smokers have “positive attitude” regarding smoking than never smokers. Approximately half of the current smokers compared to one third of never smokers think that boys who smoke have more friends and smoking makes them more attractive. On the contrary, both never and current smokers are less likely to think that girls who smoke have more friends and more attractive.
Over one third of current smokers and more than half of non-smokers definitely think that smoke from others is harmful to them with no significant difference between boys and girls. Nearly four in ten of current users of Shishah (43.6%) and one third of never users of Shishah think that Shishah is less harmful than cigarettes with no significant difference between boys and girls. This leads to a conclusion that there is misunderstanding and ignorance of the consequent hazards of smoking especially Shishah. The problem is compounded by the lack of research on Shishah and its wider acceptability and popularity in the eastern societies.
Less than half of all students were taught in schools during the past year about the dangers of smoking and one third of students had discussed during the past year reasons why people their age smoke. There was no significant difference by gender. Messages on health hazards of tobacco are being given to students at higher levels (grade 11 and beyond). As the survey data indicated that smoking is imitated at early ages, tobacco control education including school curriculum and health education needs to start at a very young age. While the survey could provide an indication of whether tobacco control was taught in the school, it cannot comment on the content or intensity of the curriculum given.
Educational program can serve a useful role in tobacco control. However, unless they are backed up by strong public health policies, which help young people, refrain from using tobacco, educational programs have only modest results.
As yet there is no comprehensive ban on tobacco advertisement in Oman, the GYTS provides very strong evidence that a total ban on tobacco advertisement is needed. Three in four students saw anti-smoking media messages in the past 30 days. Six in ten of never smokers and eight in ten current smokers saw pro-tobacco messages in newspapers and magazines during the past 30 days. One in ten of both never smokers and current smokers had an object with a cigarette brand logo on and one in ten of both never smokers and current smokers were offered free cigarettes by tobacco company representative. This could be explained by either the total lack of regulation from the Ministry of Commerce and Industry and/or that the tobacco companies pay no attention to what ever restriction imposed by the this Ministry and highlights the need for a complete ban on any tobacco promotion as part of a comprehensive ban of advertising.
One in ten of current smokers usually smoke at home. Six times as many female current smokers smoke at home compared to male current smokers (53.2% & 8.4% respectively). These data reveal that there is absence of parental guidance on objection to smoking, which is an important factor to prevent young people from smoking.
Despite a national law banning tobacco sales to minors and single stick sales, still nearly half of youth buy their cigarettes from stores and nine in ten of current smokers stated that they had an access to get cigarettes easily which encourage them to continue smoking.
The Oman GYTS 2003, has shown high prevalence of ever smoking among students in age of 13–1 5. There is an alarming growth in the number of young people who use other types of tobacco especially Shishah and chewing tobacco.
The study highlights the need for an urgent action to curb this epidemic, through a comprehensive national tobacco control legislation and other components like persistent educational messages. Recent, the Gulf Cooperation Council’s (GCC) Health Ministers have acted firmly on issues such as tobacco taxation, a move which lead to increase in tobacco prices by almost 50%. Another move was seen by individual states such as the state of Qatar which successfully became the first country to issue a comprehensive national tobacco control legislation. As we write these lines, the Kingdom of Saudi Arabia has also followed the suite. All these efforts were culminated by sighing the international tobacco control treaty (The WHO Framework Convention on Tobacco Control) also know as FCTC by three of the seven GCC states (Kuwait, Qatar, and Yemen).
Unfortunately, Tobacco companies play a very strong role in attracting young people in Oman to smoke and still controlling the markets. (promotional activities and advertisements)
The authors recommend the following:
GYTS should be repeated every 3 years as recommended by WHO and it should be an integral part of the school based surveillance system. This will provide a more comprehensive picture of tobacco- using behavior and related determinants among youth.
The following organizations, ministries and individuals have contributed towards the successful implementation of this survey:
| Dr. Ali bin Jaffer Mohamed | Director General oh Health affairs |
| Dr. Sahar Abdou Helmi | Superintendent , school health department |
| Dr. Jawad Al-Lawatia | Director, Non-communicable disease Department |
| Dr. Issa Al Shuaili | Medical officer, Department of Non-communicable disease |
| Mr. Uosif bin Said Al-Rahbi | Health Inspector, Department of non communicable disease |
| Al Sayeda Sanaa bint Hamed Al Bosaidi | Director General of Relations and Information |
| Mr. Ahmed bin Ismail Al- Boloshi | Department of Guidance and education |
| Dr. Fatima A. Awa | Acting Regional Adviser, Tobacco Free Initiative |
| Dr. Charles W. warren | Distinguished Fellow Statistician |
| Mr. Curtis Blanton | Statistician |
| Ms. Varonica Lea | Epidemiologist |
| Ms. Juliette Lee | Epidemiologist |
| Dr. Absahr Ma’mon Hassan | Head section school health , South Batina region |
| Dr. Atef Mohamed Mostafa | Head section school health , North Batina region |
| Dr. Ahmed Mohamed Anani | Head section school health , Al Dakhilia region |
| Dr. Hala Ahmed Taha | Head section school health , North Sharqia region |
| Dr. Tawfiq Asham Tawfiq | Head section school health , Dhofar region |
| Dr. Amani Edward Anis | Head section school health , Al Dhahira region |
| Dr. Mariam Abdulla Al- Wa’li | Acting head section school health , Muscat region |
| Dr. Maraiam Salem Al Khusabii | Medical Officer, Muscat region |
| Ayman Mahmod Hamid Al Boloshi | Muscat region, MOH |
| Laila Ahmed Al- Harthi | Muscat region, MOH |
| Hanaa Abdel Samia Awaad | Muscat region, MOH |
| Azan Shams Kahlan Al Batashi | Muscat region ,MOH |
| Salem Mohamed Suliman Al Raqadi | Muscat region, MOH |
| Ahmed Said Mustahil | Dhofar region, MOH |
| Mariam Mohamed Al Nofali | North Batina region, MOH |
| Noora Hamid Hamed Al Kalbani | North Batina region, MOH |
| Naima Khasif Zaid Al Mahrizi | North Batina region, MOH |
| Amna Mohamed Salm Al Khusabi | North Batina region, MOH |
| Rahma Mohamed Abd el Ghafor Al Farsi | South Batina region, MOH |
| Hafidha Said Khamis Al Khazmi | South Batina region, MOH |
| Fatma Juma Abdulla Al Khaait | South Batina region, MOH |
| Alia Saif Masood Al Bahri | South Batina region, MOH |
| Fatma Ali Khamis Al Marzoqi | South Batina region, MOH |
| Salm Mohamed Ali Al Badi | Dhahira region, MOH |
| Said amer Humaid Al Abri | Dhahira region, MOH |
| Amna Dhalam Salem Al Naimi | Dhahira region, MOH |
| Mohamed Masood Saif Al Shaqsi | Dakhilia region, MOH |
| Ali Salem Mohamed al Salmi | Dakhilia region, MOH |
| Masood Salam Mabrook Al Amri | Dakhilia region, MOH |
| Aisha Naser Ali AlAbdli | Dakhilia region, MOH |
| Samira Obiad Al Ta’ai | Dakhilia region, MOH |
| Safia Abdulla Homod Al Bosaidi | North Sharqia region, MOH |
| Riaa Said Mohamed Al Hajri | North Sharqia region, MOH |
| Hasnaa Khalfan Said Al Toqi | North Sharqia region, MOH |
| Said Ali Hamed al Satmi | South Sharqia region, MOH |
| Mohamed Suliman Al farsi | Head Section of Administration and finance |
| Suhail Hamdan Adam Al Zedjali | Financial Officer |
| Safiya Salem Abdulla Al Harthi | Secretary, School health department |
| Helal Ali Naser Al Khawaldi | Secretary, Non communicable disease department |
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