Dental Caries and Smoking Behaviors Among High School Students in Madinah, Saudi Arabia: A Cross-Sectional Study

Adolescence is critical for developing lifelong health habits, including oral hygiene. While the effects of smoking on oral health are well-documented in adults, research focusing on adolescents remains limited.

This paper aims to investigate the prevalence of smoking and its relationship with oral health outcomes, socioeconomic variables, and oral hygiene practices among high school students in Madinah.

A cross-sectional study was conducted with a sample size of 2,514 high school students (n = 1,249, 49.7% males; n = 1,265, 50.3% females) from 24 schools in Madinah, Saudi Arabia. Participants completed a self-administered questionnaire that collected data on sociodemographic factors, smoking habits, and oral health behaviors. Clinical dental examinations were conducted to assess caries prevalence using the Decayed, Missing, Filled Teeth (DMFT) index. Bivariate analysis and logistic regression were used to examine the associations between smoking status and the study variables.

The prevalence of smoking among participants was 8.6% (n = 216), with a higher proportion of males (n = 132 out of 1,249, 10.6%) than females (n = 84 out of 1,265, 6.6%) reporting tobacco use (P < 0.001). Smokers were more likely to attend public schools compared to nonsmokers (n = 190 out of 216, 88.0%, vs. n = 1,899 out of 2,298, 82.6%; P = 0.04) and had mothers with intermediate education levels (n = 108 out of 216, 50.0%, vs. n = 892 out of 2,298, 38.8%; P = 0.005). No significant differences were observed for the father's education or age. Regarding oral health outcomes, smokers reported significantly poorer self-rated oral health (n = 43, 19.9%, vs. n = 328, 14.3%; P = 0.026), but no significant association was found between smoking status and DMFT scores (P = 0.66). Smokers also reported less frequent toothbrushing (n = 132, 61.1%, brushing regularly vs. n = 1,686, 73.4%, for nonsmokers; P = 0.001).

Smoking prevalence among high school students in Madinah was 8.6%, with higher rates observed among males and students attending public schools. Smoking was associated with poorer self-rated oral health and less frequent brushing habits. These findings highlight the need for targeted oral health education and smoking prevention programs in schools to address modifiable risk factors and promote healthier behaviors.