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Objectives . The main objectives of this study were to estimate the prevalence of tobacco use and behavioral patterns among undergraduate students at higher education institutions in the Jazan Region of Saudi Arabia during the 2011-2012 academic year and to investigate factors that contribute to tobacco use by gender.  Methods . A cross-sectional study of 4100 undergraduate students was conducted. An anonymous self-administered questionnaire was used to collect information on the extent and pattern of tobacco consumption and factors associated with tobacco use.  Results . Current smokers accounted for 16.8% (95% CI: 15.6–18.1) of the population sampled; 25.6% (95% CI: 23.8–27.5) of males were current smokers, whereas only 4.6% (95% CI: 3.6–5.8) of females were current smokers ( P  = 0.000). Multivariate analysis revealed that the most important variables explaining tobacco use among study participants were the use of khat (OR = 14.05;  P  = 0.000), smoking status of friends (OR = 2.25;  P  = 0.000), and substance use by friends (OR = 1.81;  P  = 0.001).  Conclusions . The results demonstrated that khat use was the main predictor for smoking in Jazan for both males and females. Interventions should be designed to reduce the use of tobacco among university students.

Tobacco Use among University Students of Jazan Region: Gender Differences and Associated Factors