Prevalence and Determine Knowledge and Attitude of Tobacco Smoking Among Secondary School Students in Sulaimani City

Objective: This study aimed to determine the prevalence rate and assess knowledge and attitudes among secondary students in Sulaimani city. Methods: A cross-sectional study was conducted among school students, from eight randomly selected secondary schools in Sulaimani city, Iraq. 1200 students participated in this study during six months from October 2022 to April 2023. The respondents were explained about each section of the questionnaire form. It describes behaviors, knowledge, beliefs, opinions, and other variables related to tobacco use.   Results: The prevalence rate of current tobacco use (all types) is 21.8%, from this rate; 13.2% were cigarette smoking, 11.9% waterpipe, 24.7% used electronic smoke such as vape and pods and 50.2% of students used all types of tobacco product. The prevalence rates of tobacco use in males (31.3%) and females (12.1%). The rates were higher among students whose mother and father, schoolmates, relatives, and friends were smokers than those whose parents, schoolmates, relatives, and friends were non-smokers. A higher rate of smokers have not thought about the harmful of other people’s cigarettes on them, 16.7%, 25%, 9.9%, and 4.8% of smokers have not thought definitely, probably not, probably yes, and definitely yes. Regarding the attitude of the smokers, it showed statistically that there were significant associations for example only 6.6% of smokers were with the banning of smoking in public places while 21.7% of them were with not banning smoking in public places.  Conclusion: Despite the prevalence rate of smoking in Sulaimani City being relatively lower than in other cities in Iraq the rate is still high. The rate was higher in males than females. In addition, there were factors connected with smoking initiation which are parents, schoolmates, relatives, and friends smoking. A higher rate of smokers did not think about the harmful of other people’s cigarettes to them and a lower rate of smokers were with the banning smoking in public places.