National prevalence, perceptions, and determinants of tobacco consumption in Saudi Arabia

Abstract

Introduction 
 Tobacco use has been associated with many health risks that can lead to premature death. This study aims to assess the national prevalence of tobacco consumption and the associated determinants in Saudi Arabia. 
 Methods 
 The study involved a cross-sectional national survey of 5175 individuals conducted across the 13 official regions of Saudi Arabia. The sample included individuals aged 18 years and above from both genders recruited using a quota sampling technique. Data collection was carried out between September 2018 and May 2019 through Web-based computer-assisted telephone interviews (CATIs). Participants were asked to report their current consumption of tobacco products including cigarettes, shisha (waterpipe), smokeless tobacco, cigars, pipes, and electronic cigarettes/vaping. Knowledge of specific health risks associated with smoking and public perceptions of the smoking phenomenon were also assessed among never smokers, smokers, and former smokers.
 
 Results 
 The national prevalence of tobacco consumption was 24.02% (1120/5175). Cigarettes were the most prevalent tobacco product consumed (16.18%; 95% CI: 14.5881–17.7663), and daily cigarette smoking prevalence was the highest (14.12%; 95% CI: 12.6433–15.5924). Shisha smoking prevalence was 8.12% (95% CI: 6.8054–9.4352). E-cigarette use prevalence was 2.22% (95% CI: 1.5770–2.8711). The most common tobacco product used among males was cigarettes (15.13%; 95% CI: 13.58–16.67), while shisha was commonly used among females (1.57%; 95% CI: 1.11–2.04). Cigarette smoking prevalence was the highest in the Aljawf region (21.12%; 95% CI: 17.07–25.18), shisha smoking prevalence was the highest in the Makkah region (12.41%; 95% CI: 8.64–16.17), whereas smokeless tobacco use was prevalent in the Najran region (4.75%; 95% CI: 2.81–6.70). Males (AOR: 8.17; 95% CI: 5.98–11.71; P < 0.0001), young adults below 45 years of age (AOR: 2.12; 95% CI: 1.50–2.98; P < 0.0001), and those with below a bachelor’s degree (AOR: 1.34; 95% CI: 1.01–1.77; P = 0.0396) were more likely to consume tobacco compared with others. The population mean knowledge scores of health risks associated with smoking among smokers was 1.91 ± 1.72 (Range: 0–10), with the highest knowledge scores (2.16 ± 1.68) among former smokers. Only 46.53% (95% CI: 44.30–48.75) of the population are bothered “to very large extent” by smoking health consequences.
 Conclusions 
 Tobacco consumption is prevalent in Saudi Arabia. Different forms of tobacco use were reported, and the most common was cigarettes, followed by shisha and then electronic cigarettes. Tobacco use remains one of the major threats to the health of the population in Saudi Arabia.