Peer and Social Correlates of Smoking among Saudi Youth.

Smoking declines are uneven around the world, and we have few studies on the correlates of youth smoking in contexts like Saudi Arabia, where declines have been slowest. Using a broadly socio-ecological framework and network data, we report on one of the few studies to simultaneously examine peer, family, and school features associated with smoking in the Saudi context. We find strong and consistent peer and family associations with both occasional and regular smoking via direct modeling (level of peers/family that also smoke) and substantive interactions (lying to parents in the family domain, engaging in unsupervised youth-centric activities, or seeking popularity in the peer domain). Although our design precludes causal claims, our results are consistent with smoking initiation being driven by occasional use surrounding attempts to gain youth social status, whereas regular use depends on implicit family and peer acceptance.