ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1701571
Knowledge, Attitude, and Practice Towards E-Cigarettes Among Adults in the Kingdom of Saudi Arabia: A Cross-Sectional Study
Provisionally accepted
Rahaf Saad Alhemayed
Mohammed Khaled Al-Hanawi*- King Abdulaziz University, Jeddah, Saudi Arabia
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Background: Amid increasing evidence of the health risks linked to traditional combustible cigarettes, electronic cigarettes (e-cigarettes) have become widely adopted. However, the rise in e-cigarette use also poses emerging health risks. This study examines the knowledge, attitudes, and practices (KAP) related to e-cigarette use among the general population in Saudi Arabia. Methods: This cross-sectional study collected data through a structured, self-administered online questionnaire from 1233 participants during the period from 10 April 2025 to 4 May 2025. Descriptive statistics, including frequencies and percentages, were used to summarise participants' demographic and socio-economic characteristics. Chi-square (χ²) tests were used to examine the bivariate associations between socio-demographic variables and each KAP domain. Additionally, multivariable logistic regression analyses were performed to examine factors associated with sufficient knowledge, positive attitudes, and positive practices regarding e-cigarette use. Results: The mean knowledge score was 9.50 (SD = 3.49, range: 0–15), with approximately two-thirds of the sample (n = 819) classified as having sufficient knowledge. The mean attitude score was 23.96 (SD = 6.68, range: 9–35), with 59% of the sample (n = 731) exhibiting a positive attitude. The mean practice score was 1.56 (SD = 1.09, range: 0–3), with less than half the sample demonstrating positive practice. Participants with sufficient knowledge were over twice as likely to hold a positive attitude [adjusted odds ratio (AOR) = 2.156; 95% confidence interval (CI): 1.509–3.080; p < 0.01), while both sufficient knowledge (AOR = 2.195; 95% CI: 1.343–3.589; p < 0.01) and a positive attitude (AOR = 13.842; 95% CI: 8.190–23.396; p < 0.01) strongly associated with positive practices. Conclusions: This study demonstrated positive correlations among knowledge, attitude, and practice of e-cigarettes, emphasising that tailored, nationwide awareness campaigns addressing diverse socio-demographic profiles can improve knowledge, modify attitudes, and ultimately reduce e-cigarette use.
Keywords: attitudes, e-Cigarette, health risks, knowledge, Practice, Saudi Arabia
Received: 08 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Alhemayed and Al-Hanawi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mohammed Khaled Al-Hanawi, mkalhanawi@kau.edu.sa
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