ABSTRACT
To identify the prevalence and predictors of the water-pipe [WP] smoking epidemic in the Kingdom of Saudi Arabia [KSA]. A cross-sectional study conducted with 16-18 year-old high school students in Riyadh, Saudi Arabia. Of the 1272 participants, 414 [33.0%] reported having tried WP smoking. Of this group, 141 [34.1%] were female and 273 [65.9%] were male. Further, 129 [10.2%] students were current WP smokers who had used at least one rock in the past month; 20 were female [1.6%] and 120 were male [8.6%]. Regarding age, 276 [68.1%] students who tried WP smoking at least once began when they were over 11 years of age, whereas 129 [31.9%] began WP smoking at or before 11 years of age. Adjusted odds ratios showed that trying WP smoking at least once was associated with smoking after the age of 11 [p = 0.021, OR 7.7; CI: 1.4-43.6] and accepting water-pipes from a friend [p = 0.024, OR 10.6; CI: 1.4-83.4]. A high prevalence of WP smoking exists among male and female high schools students in Riyadh, KSA. WP smoking was reported to begin in early adulthood. WP smoking [water-pipe smoking], KSA [Kingdom of Saudi Arabia], STS [Saudi Thoracic Society], GYTS [Global Youth Tobacco Survey], CI [confidence interval]