Background: Smoking among university students is a social and public health problem worldwide. There is a highprevalence of smoking in Saudi Arabia.Aims: To investigate the factors associated with the onset and cessation of smoking behaviour among university studentsin Saudi Arabia, and establish what contributes to changes of students’ smoking behaviour.Methods: A sample of 340 students from a national university in Saudi Arabia was randomly recruited and surveyedtwice at a 5-month interval. Multiple ordinal logistic regression was run to compare changes in social, psychological andpolitical factors and their impact on students’ smoking behaviour.Results: We found that beliefs supporting nonsmoking (e.g., religious prohibition of smoking) correlated with changesin smoking behaviour among university students [adjusted odds ratio (AOR) = 1.89, 95% confidence interval (CI) = 1.23–2.91]. There was a significant positive correlation between government policy and changes in male university students’smoking behaviour (AOR = 0.46, 95% CI = 0.29–0.072). The psychological effect of smoking, such as releasing psychologicalpressures, was also correlated with changes in smoking behaviour (AOR = 0.31, 95% CI = 0.21–0.47).Conclusions: Our study suggests that the government can play a significant role in curbing smoking by strengtheningbeliefs promoting antismoking among university students, by developing corresponding policies against smoking, andby providing psychological consultation for them.
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