Tobacco Use Trends among Youth in Saudi Arabia: 2007–2022

Sarah S Monshi^1,2*Eman D El Desouky³Shaikha K Aldukhail⁴Abdulmohsen Hamdan Al-Zalabani⁵Mohammed M Alqahtani^6,7,8Mervat El Dalatony⁹Mosa A Shubayr¹⁰Ahmed A Elkhobby¹¹Mohammed S Aldossary³

• ¹Umm Al Qura University, Mecca, Saudi Arabia
• ²Department of Health Administration and Hospitals, College of Public Health and Health Informatics, Umm Al Qura University, Makkah, Saudi Arabia
• ³General Directorate of Research and Studies, Ministry of Health, Riyadh, Saudi Arabia
• ⁴Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University,, Riyadh, Saudi Arabia
• ⁵Department of Family and Community Medicine, College of Medicine, Taibah University, Madinah, Al Madinah, Saudi Arabia
• ⁶College of Applied Medical Science, King Saud bin Abdulaziz University for Health Science, Riyadh, Riyadh, Saudi Arabia
• ⁷King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
• ⁸Department of Respiratory Services, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
• ⁹Department of Public Health and Community Medicine, Faculty of Medicine, University of Menoufia, Shibin el kom, Egypt
• ¹⁰Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
• ¹¹Tobacco Control Program, Ministry of Health, Riyadh, Saudi Arabia

Introduction: Tobacco use is a major global public health challenge, causing millions of deaths annually. In Saudi Arabia, increasing adult smoking rates highlight the need for improved tobacco control measures. Aim: This study examined trends in tobacco use among youth in Saudi Arabia from 2007 to 2022, evaluating shifts in the determinants of tobacco use and the effectiveness of control measures over time. Methods: We analyzed three waves of the Global Youth Tobacco Survey (GYTS) conducted in Saudi Arabia (2007, n = 2,574; 2010, n = 1,797; 2022, n = 5,610). The GYTS uses a two-stage cluster sampling design to select students aged 13–15 from intermediate schools, with a focus on tobacco use trends and related behaviors. Results: This study revealed a substantial decline in current tobacco product usage, dropping significantly from 15.9% in 2007 to 9.4% in 2022 (B = –0.44, p = 0.030), and a decrease in exposure to second-hand smoke from 27.9% in 2007 to 18.1% in 2022. However, the proportion of individuals aged 7 years or younger who initiated cigarette smoking rose from 9.1% in 2007 to 17.1% in 2022. There was a 6.4% increase among female youth who thought that smoking made people feel comfortable across this time period (B = 0.55, p = 0.033), and this population demonstrated a significant decrease in the intention to quit smoking from 65.7% to 52.2% (B = –0.895, p = 0.010). Conclusion: Although overall tobacco use decreased, alarming trends, emerged, such as earlier smoking initiation and declining intentions to quit among females. Future interventions should focus on preventing early tobacco use initiation by addressing misconceptions, promoting cessation, and enforcing restrictions on youth access to tobacco products.