Oral Health Effects of Tobacco and E-Cigarettes in Madinah

Ahmed M Kabli¹Rawan K Kamal¹Ahmed A Othman²Fatimah M Almehmadi³Shuruq A Alrehaili³Alanoud S Almurowbae³Rahma F Alhazmi⁴Sarah B Alrashidi⁵Mahir A Mirah^6*

• ¹Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia
• ²Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia
• ³Internship Program, College of Dentistry, Taibah University, Madinah, Saudi Arabia
• ⁴College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
• ⁵RAM Clinics, Yanbu Al-Bandar, Saudi Arabia
• ⁶Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madinah, Saudi Arabia

Tobacco smoking and the use of electronic cigarettes (e-cigarettes) are well known to harm oral health, but the dangers of e-cigarettes are still not fully acknowledged, especially in Saudi Arabia where their use is steadily increasing. This study explored awareness of the oral and dental health consequences of tobacco and e-cigarette use among residents of the Al-Madinah region and compared awareness levels across smokers, e-cigarette users, dual users, and non-smokers. A cross-sectional online survey was carried out on 278 participants who are 16 years and over in 2025. A validated self-administered questionnaire was used in the collection of data on demographic characteristics, smoking habits, oral health habits, and awareness of smoking-related oral health risks. Chi-square and Fisher Exact tests were used to analyze the data at a statistical significance level of p <= 0.05. Of the respondents, 6.8% were traditional smokers, 6.5% were e-cigarette users, 2.2% were dual users and 84.5% were non-smokers. Although more than 80% identified smoking as a cause of oral health problems such as cancer, discoloration, halitosis, and impaired healing, only 17.6% considered e-cigarettes as harmful. The non-smokers and cigarette smokers were more aware than the e-cigarette and dual users who were more likely to underestimate the risks associated with e-cigarettes. The results indicate that although the level of awareness on the negative effect of tobacco is high, the misconceptions on e-cigarettes are still present, thus suggesting the need for a public health campaign.