In the arena of human life, health is one ofthe important factors that every individual has a right to. The word‘health’ is a useful and active concept. In its apparent meaning,health implies failure of the disease to be present. Nevertheless,the health of young people involves much more than a mere absence ofsickness. According to World Health Organization (WHO) health definedas, “a state of complete physical, mental, and social well-beingand not merely absence disease or illness or infirmity” (WHO,1948). Wilson, Mabhala, &amp Messay (2012) argues that health is aresource of everyday life, not the object of living, but it’s realconcept emphasizes on social and personal resources as well asphysical capabilities. There has existed an increased understandingof how health fits into a wider cross-sectional, cross-border andglobalized framework as argued by Henefeld, (2014). He emphasizes onfour guidelines that discourse the matters of health, which includethe conditioned application of health ethics schemes, acknowledgmentsof the worldwide right to health, employments of policies concerninghealth promotion, and amalgamation of gender techniques into healthpolices (Henefeld, 2014). Global health, therefore, entails awidespread effect that impacts a large number of people across theborders of geography, time, and culture (McCracken,&amp Phillips, 2012).

According to U.S. Department of Health andHuman Services (2012), smoking is global epidemic among children.Smoking among youth in Oman has significant implications for thisnation’s public health and economic health in future (WHO, 2015). Smoking is considered as one of the most preventable causes of deathin the world today, and it is implicated as a significant aspectcontributing to morbidity and mortality across the globe (WHO, 2015).Report from WHO attributes over five million deaths a year tosmoking, and this statistic is expected to rise about ten million bythe year 2020. Recent studies show that people start to smoke at anearlier age which is an indicate of increased prevalence of tobaccouse in children and adolescent youths. Additionally, the adolescentstarting to smoke at early age will tend to be more addicted tocigarettes and less willing to quite (U.S. Department of Health andHuman Services, 2012).

Oman is among the countries that haveexperienced rapid economic, socio-demographic and epidemiologicaltransition over the past few decades (Al Muzahmi et al. 2013). Thesociocultural and economic pattern of the Omani population does notrelate to the Western countries or any other developing countries inAsia. The research conducted by Al Muzahmi et al. (2013), on the OmanGlobal Youth Tobacco Survey (OGYTS), had the chief aim of monitoringthe trends of tobacco use among adolescent youth in Oman. In manydeveloping countries, studies have brought out that most people startsmoking at teenage and most at the age of 15 years (Gabbleet al.2015).

The widespread of smoking among the adolescentyouth in Oman can be reduced, only if the primary prevention focusmust be on the youth and young adults. Whitehead (2009), suggest thatthe nurses should not only focus on the traditional health promotionof disease prevention and altering the behavior of individual ontheir health, but also they should provide multidisciplinaryknowledge and experiences in health promotion among youths. OttawaCharter for Health Promotion, 1986, provides exigent circumstancesand possessions for health to include peace, income, education, astable ecosystem, shelter, equity and social justice. Therefore, Omannurses should embrace their nursing code of conduct in promotinghealth by serving and protecting the public through the delivery ofqualified, available, operative, and suitable nursing care. The chiefobjective of this report is to identify the role played by nurses inpromoting and preventing smoking among adolescent youths in Oman.


According to Center for Disease Control (CDC)(2015), Epidemiology is the technique used to determine the causes ofhealth consequences and diseases in a given population. It providesscientific, systematic, and data-driven results of the distributionand elements of health-related occasions, in this case, smoking amongadolescent youth in Oman. This review is quite significant in thestudy because it provides the information or data that will guide andpromote healthcare plan towards reducing smoking among youths inOman.

Smoking is one of the leading causes ofpreventable morbidity and mortality globally. In developing Arabcountries and the emerging economies, the adolescent is particularlylikely to initiate and maintain smoking as public health and thegovernment may not be in a position of preventing its use (Madi, &ampHussain, 2008). Smoking in Oman mainly tobacco has become widely spread especiallyamong adolescent and youth with an openness of the country and worldmarkets (Al Muzahmi et al., 2013). However, one the main goal of theMinistry of Health (MOH) in Oman is to control and prevent tobaccosmoking among the youths. Globally, smoking causes coughs, increasednumber and severity of respiratory illness, retardation in lunggrowth, and unfavorable lipid profile. Smoking also causes addictivebehaviors, and it is associated with alcohol and other illicit drugs(U.S. Department of Health and Human Services, 2012). In Oman youthsstart to smoke at the age of 15 years, and this earlier age of onsetof smoking marks the advent of vulnerability to harmful compounds ofsmoking (Al Muzahmi et al., 2013).

According to the report provided by GlobalYouth Tobacco Survey (GYTS), in the Gulf region smoking hasguaranteed and earned a grievous public wellness worry. The study byGlobal Youth Tobacco Survey (2010), shows that 21.9% of youth in Gulfregion are smoking. The GYTS also indicates that in the United ArabEmirates, 14.3% of young males, 24% of adult males, 2.9% of youngfemales, and 1% of adult females are currently smoking (Al Muzahmi etal., 2013).

In Oman, Research conducted by Global YouthTobacco Survey Oman 2010 shows that a total of 3.3% of student in agebetween 13-15 years and 9.2% of the student in all ages are currentsmokers. Similarly, 1.5% of the youth between 13-15 years arecurrently smoking water pipes (shisha) with no big difference betweenboys and girls. For smokeless 5.4% of the student reported that theyare using smokeless tobacco. In the report, almost 48.6% of youngstudents aged 13-15 years who are current smokers have the desire toquit smoking while 61.7% tried to quit since last year but failed (AlMuzahmi et al., 2013). Besides, 25.3% of the students age between13-15 years in Oman thinks that it is secure to smoke for solely ayear, or two provided they quite after that, GTYS Oman, 2010. Resultsalso show that almost 12% of student age between 13-15 years and 17%of student in different age groups lives in homes where other peopleor their parents smoke. Overall, 44% of smokers between age 13-15years and 55.2% of current smokers of the youths in all age groupsare exposed to environmental smoking at home and public areas, GTYSOman, 2010 (Al Muzahmi et al., 2013). Adolescent stage in youths issaid to be a significant event in a person’s lifetime, and this isbecause it is a period when teens tend to acquire lifetime habits andattitudes. Therefore, it necessary to employ health promotiontechniques focusing on the adolescent youth because they are theprimary target markets for the tobacco industries (U.S. Department ofHealth and Human Services, 2012). Additionally, according toAl-Lawati et al. (2008), 26.6% of the adolescent in Oman were everusers of water pipes. This is also similar to the report thatindicates that 27% of water pipe smokers are among Arab-Americanadolescent

Separately, at the junior stage level, most ofthe youths are aware that smoking is harmful to their health.According to the GTYS Oman, 2010, 98% student of age 13-15 yearsacknowledges that smoking is detrimental to their health. The tablebelow shows the trend of tobacco, shisha, and smokeless tobacco amongthe youths in Oman in the year 2003, 2007, and 2010.

Source: AlMuzahmi et al., 2013. GTYS Oman,2010.

The above figure indicates that when youths ofthe adolescent stage and adequately provided with health educationand awareness programs in Oman, it can help to reduce smoking amongthe youth. Through comparing the result of the three surveys, itshows that current smokers acknowledge that smoking in harmful totheir health. Therefore, both primary, secondary, and primaryprevention interventions will be employed to help prevent and reducethe chances of smoking among Oman youths to lower the risk of futurehealth complication resulting from smoking.

Health promotion model

The purpose of HP model is to assist nurses inempathizing the primary causes of health compartments as a model ofbehavioral counseling to encourage healthy lifestyles (Naidoo, &ampWills, 2016). As noted by Pender (2011), Health promotion models aretheories used in health education and health promotion. The qualityof this conception is established on the determination of healthbehavior through perceptions about the epidemic and the strategiesaccessible to reduce its happenings. In this case, we adopt threemodel of HP created by Tannahills overlapping spheres which includehealth education, health protection, and disease prevention(Tannahill, 2009). The areas will be implemented and discussedthroughout this study. Health education will focus on the learningneeds and the creation of awareness among the adolescent youth of thetargeted population and employ more initiative programs that willhelp the reduce smoking. With this models, the initiated programswill be implemented effectively by nurses and every adolescent youthin Oman population will not be neglected.

Health education

According to WHO (2015), health education has along tradition in public health practice. The organization noted thathealth literacy was a question of professionals informing people ofthe health risk and giving advice on how people should live healthylives (WHO, 2015).According to Laverack (2015), public health is the prearranged effortof the society to preserve people healthy and avert injury, illness,untimely death. It involves a mixture of agendas, guidelines,strategies that defend and encourage the health of all individuals.In this case, Green, Tones, &amp Woodall (2015), notes that healtheducation raises public awareness of the consequences related tosmoking among the youth. Civic education to the public and in theschool referred to the alarm on how to avoid chances of smoking.Therefore, healthcare professionals have a prominent role inproviding primary education and awareness.This is because they have the confidenceof the population, the media, and their voices are heard a vast rangeof social, economic, and political arenas transversely (Green, Tones,&amp Woodall, 2015).

Healthcare professionals and public nursesshould, therefore, at individual level educate the youths both inschool and homes on the harms of smoking and consequences tosecond-hand smoke (WHO, 2005).At the community level, nurses should initiate programs that followup youths of the adolescent stage and come up with policy measure byengaging Oman youths in efforts to promote smoke-free in school, athomes, and workplaces and lengthening the obtainability of smokingcessation resources (WHO, 2005). Conversely, at the society level,nurses should raise their voice and weight to governmental controllike education the government of Oman to increase the tax on tobacco.On the other hand, health education of smoking will create awarenessto the young ladies who smoke on the serious risk of developingcervical cancer. Cervical cancer is a leading killer cancer amongteenage women in the world, and more than half a million are casesare diagnosed annually as stipulated by MacCracken &amp Phillips(2012).

Nurses are the character and image of health inencouraging smoking-free lifestyles and cultures (Kearney &ampThomas, 2009). Through their professional activities, during thissession nurses will help by bestowing advice, guidance, and respondto questions related to smoking and its health effects to thetargeted group (WHO, 2005).In this case, nurses and healthcare professionals will serve as anorientation for the media, educating public and policy makers (WHO,2005). Health education should also involve training of the studentsincluding those of age between 13-19 years to change their practicebehavior. According to The Australian Nursing Federation, publiceducation is significantly important in reducing smoking among theyouths. That health education should involve a well-funded nationalanti-smoking campaign to help deliver key messages warning youthsabout the dangers of smoking (Kearney &amp Thomas, 2009). Therefore,during the session healthcare professional should continue witheducation programs to promote the implementation of effectiveintercessions to reduce smoking among adolescent youth in Oman.Nursing and midwifery interventions are the primary keys to thedeterrence of problems associated with smoking. This is because theyhave the opportunity to dangerous encouragement behavior in numeroussettings and with suitable support, education, and evidence-basedguidelines, they make a vast contribution to the prevention ofsmoking among adolescent youth (Kearney &amp Thomas, 2009).

Finally, as presented by Gabble et al. (2015),many potential benefits arise from school-based youth interventionsincluding their reach, impact, relevance to youth. These types ofeducation intervention allow for enhancement communication andengagement with the parent of adolescent youth smokers as parents canbe sent information about smoking and cessation. Additionally, Nursesshould use other educational programs such as newsletter, posters,and adverts to facilitate educational awareness on the risk ofsmoking.

Health prevention

Health prevention is a defined interventiondirected to averting the emergence of particular disease or epidemicproblem and reducing the incidence and prevalence in a givenpopulation (WHO, 1948).Madi and Hussain (2008), notes that the discourse of prevention isbased on modern epidemiological knowledge, which purposes the controlof spread disease (in this case smoking) and reduces the risk of thedegenerative problem. Therefore, community health nurses willparticipate, and the main role is to promote, maintain, and restorethe health the young smokers. In achieving this, nurses willincorporate both primary and secondary level to prevent smoking amongthe adolescent youth.

Primary prevention

Primary prevention involves reducing the riskfactors of the smoking among the youth. Nurses can achieve thisthrough an implementation of health education in pre-school, primary,and third level school. Nurses should also increase awareness of thedeterminants of health and effective approaches(Health Promotion Strategic Framework,2013). Campaignprograms should be conducted both at national and community level toraise an alarm on the risk factors such as cardiovascular diseaseresulting from smoking (Health Promotion Strategic Framework, 2013).School-based programs are more effective in preventing adolescentsmoking. Other healthcare professionals and nurses should conduct thesurvey in every school in Oman and assess the school health policiesand programs (Brassard, 2013). On the other hand, to reach the otheryouth population outside the school, the campaign should be raised toincrease awareness of smoking cessation. The campaign should entailactions that educate and raise the empathetic of well-being riskassociated with smoking, and motivate both adolescent and the generalpopulation to take action, support, and cease smoking. Nurses in Omanshould become aware of smoking prevention program and provide bothprofessional expertise and health preventions techniques to empowerthe population (Brassard, 2013).

Secondary prevention

Secondary interventions will involve healthpromotion measures that help to reduce the prevalence of smoking.Nurses through the MOH of Oman should introduce cessation serviceswithin school institutions and healthcare organizations. GTYS-Oman,2010 recommends for a continuation of the ongoing anti-smokingcampaigns, which focuses on protecting young people (Al Muzahmi etal, 2013). The screening program is the most appropriate way ofidentifying the condition and complication for immediate healthaction. Healthcare professionals including nurses should providetesting services in schools to check the level of smoking among theadolescent youth in Oman. This program should also be employed inhealthcare institutions for those nurses who have direct contact tothe youths (AlMuzahmi et al, 2013).

Health protection

Al Muzahmi et al., 2013, asserts that healthprotection involves the application of laws at global, national, andlocal level. Therefore, for the GTYS-Oman, to attain their objectsthey have collaborated with WHO, CDC, UNICEF, and The Office ofSmoking and Health to prevent smoking among the adolescent youth inOman. In England, the government is committed in in improving publichealth in communities across England (HM Government, 2011). Healthprotection offers equal opportunity for people to relish theuppermost possible level of health. The UK has also adopted mediaprevention programs which are by far most expensive program forintervention. This is the same in Oman, because health protectionagainst smoking among adolescent youth will involve interventionsthat prevent people from smoking. To achieve these, nurses shouldcollaborate with MOH and government of Oman to facilitate activeinterventions like mass media campaign that will empower attitudes ofadolescent youth to actively involved in smoking prevention. On theother hand, in US, since 1994, several law have been implemented thatprotect smoking among youth. The US department of justice havebrought lawsuits against tobacco companies thereby introducing thescience of tobacco control (U.S. Department of Health and HumanServices, 2012). This strategy can be achieved through implementationof legislation by Oman department of justice, and programs in theenvironmental protection and community care facilities (Madi &ampHussain, 2008). Additionally, the government of Oman should enforcelaws that increase tax for tobacco companies to reduce tobacco sellamong the youth.


Smoking is global epidemic among youths. Theprevalence of smoking has become a growing healthcare concern both atglobal, national, and local level. Adolescent young people are thetargeted market for tobacco industries. To prevent this situation,health promotion models should be employed by nurses to reach theteenage youth in Oman. These interventions and programs shouldeducate the youths on the risk of smoking. Nurses are thereforerequired to provide their professional expertise by increasingawareness through education and campaigns to promote health andwellbeing.


Al Muzahmi etal. (2012). Global Youth TobaccoSurvey (GYTS-Oman, 2010). WHO-Country Reports.

Al Lawati etal. (2008). Prevalence andDeterminants of Water Pipe Tobacco use among Adolescent in Oman.Sultan Qaboos University MedicalJournal, Vol. 8 (1) p.37-43.

Brassard, B. A. (2013). The Nurse Role inTobacco Prevention and Cessation for Adolescent. American NursesFoundation (ANF)

Canter for Disease Control (CDC). (2015). Whatis Epidemiology: Excellence inCurriculum Innovation through Teaching Epidemiology.

Gabble et al.(2015). Smoking Cessation Interventions for Youth: A Review ofLiterature. Toronto: Ontario TobaccoResearch Unit.

Green, J. Tones K, Cross R, Woodall J (2015)Health promotion: Planning andstrategies. (3rded) Los Angeles: SAGE Publications.

HM Government. (2011). Healthy Lives, HealthyPeople: A Tobacco Control Plan for England.

Hanefeld, J. (2014) Globalizationand health. United Kingdom: OpenUniversity Press.

Kearney, G., &amp Thomas, L. (2009).Submission to National Preventive Health Taskforce: Discussion Paper.Australian Nursing Federation (ANF)

Laverack, G. (2015) Publichealth: Power, empowerment and professional practice.United Kingdom: Palgrave Macmillan.

Madi, H. H., &amp Hussain, J. S. (2008).Health Protection and Promotion. EasternMediterranean Health Journal, Vol.14.

McCracken, K. and Phillips, D.R. (2012) Globalhealth: An introduction to current and future trends.London: Taylor &amp Francis.

Naidoo, J. and Wills, J. (2016) Foundationsfor health promotion. UnitedKingdom: Bailliere Tindall.

Pender, N. (2011). Health Promotion ModelManual. University of Michigan. Retrieved from

Tannahill, A. (2009). Health Promotion: TheTannahill Model Revisited. PublicHealth. Vol. 123 (5) p. 396-399.DOI:

The Health Promotion Strategic Framework.(2013). Main Report. Retrieved from

U.S. Department of Health and Human Services.(2013). Preventing Tobacco Use among Youth and Young Adults. A Reportof the Surgeon General, Atlanta.

Wilson, F., Mabhala, M. and Massey, A. (2014)Health improvement and well-being:Strategies for action. UnitedKingdom: Open University Press.

Whitehead, D. (2009) Publichealth and community nursing: Frameworks for practice.Edited by Dianne Watkins and Judy Cousins. (3rd ed). Edinburgh:Elsevier Bailliere Tindal.

WHO. (1948). OttawaCharter for Health Promotion, 1986: Health Promotion.

World Health Organization (WHO). (2015). HealthPromoting Schools Initiatives in Oman: A WHO Case Study inIntersectoral Action.

World Health Organization (WHO). (2005). TheRole of Health Professionals in Tobacco Control.