Research Brief | Saudi Arabia youth prefer high-nicotine e-cigarettes; retail store and online are the main purchasing channels

Important disclaimer below — please read carefully.

2Firsts, September 4, 2025 — On August 14, 2025, Frontiers in Public Health published an original research article titled “Electronic cigarette use in Saudi Arabia: a cross-sectional study on emerging trends and public health concerns” The authors are from Imam Abdulrahman Bin Faisal University, King Saud University, and the College of Pharmacy at Taif University, among other institutions. Using a nationwide online questionnaire, the study describes adult e-cigarette use patterns, acquisition channels, motivations, and risk perceptions in Saudi Arabia, and reports self-reported adverse effects and subgroup differences, providing reference data for future regulation and public-health interventions.

Main content and conclusions

Methods

The study used a descriptive cross-sectional design* and received ethics approval (IRB-2024-05-735). The survey was conducted from October to January via convenience and snowball sampling, recruiting respondents through social media. Inclusion criteria were adults (≥18 years) in Saudi Arabia who were current smokers or former smokers.

A “descriptive cross-sectional study” surveys a group of people at a single point in time to describe their current status and distribution; it does not determine causality.

The questionnaire, adapted from validated instruments and finalized after expert review in pharmacy and a small pilot, consisted of closed-ended items covering demographics (age, sex, marital status, region, education, income), behaviors (initiation time, frequency, duration, whether nicotine is used and at what strength), acquisition channels (retail stores, online), motivations (cessation, flavor preference, cost and convenience), risk and addiction perceptions, and self-reported adverse effects.

Statistical analyses included descriptive statistics, chi-square tests, one-way ANOVA, correlation analysis, and multinomial logistic regression (significance threshold p≤0.05), with group comparisons among dual users, exclusive e-cigarette users, and former users.

Key findings

Study design

• Type: Cross-sectional survey
• Sample: 441 adults (current and former smokers)
• Method: English questionnaire distributed via social media using convenience and snowball sampling
• Analysis: Descriptive statistics, chi-square, ANOVA, correlation, and multinomial logistic regression

Population characteristics

Sex: 86% male

Age: 63% were 18–28 years old

Socioeconomics/education: Higher usage among those with lower income (<US$1,333/month) and lower education

Geography: 53% lived in the Eastern Province

User types:

• 47% dual users (e-cigarettes + conventional cigarettes)
• 31% former users (previously used e-cigarettes to aid quitting)
• 22% exclusive e-cigarette users

Use patterns

• 50% used e-cigarettes daily
• 26% preferred high-nicotine liquids (≥16 mg/mL)
• 43% purchased from retail stores; 27% purchased online
• 44% reported adverse effects (most commonly shortness of breath, phlegm, and chest pain)

Motivations

• 45% to quit smoking
• 35% for flavor variety
• 29% believed e-cigarettes are safer than conventional cigarettes
• 22% cited cost

Perceptions and attitudes

• Information sources: 69% learned about e-cigarettes from friends/neighbors; 37% from the internet
• 61% supported stronger government regulation
• While most believed e-cigarettes are less harmful and less addictive than cigarettes, nearly half thought they might cause cancer or stroke

Conclusions

• The sample reveals a usage profile dominated by young men, with a high proportion of dual use.
• Self-reported adverse effects are not uncommon, and a majority support stronger regulation.
• The authors offer data to inform policies on nicotine strength, sales channels, age verification, and health education.

Limitations (as noted by the authors)

• Cross-sectional design and self-report may limit causal inference and introduce recall/social desirability bias.
• The questionnaire was only in English, and the sample skewed male and young, limiting representativeness.
• Convenience/snowball sampling constrains generalizability; future studies should expand sample size, balance sex and age, and offer multilingual versions.

Paper information

Title: Electronic cigarette use in Saudi Arabia: a cross-sectional study on emerging trends and public health concerns

Authors: Farah Kais Alhomoud et al.

Publication date: August 14, 2025

Journal: Frontiers in Public Health (Original Research)

DOI: 10.3389/fpubh.2025.1574623

Ethics approval: IRB-2024-05-735

All images in the article are from the paper.

Cover image generated by ChatGPT.

Disclaimer:

1.This article is a summary created by 2Firsts based on a published scientific paper. Its purpose is to make complex research findings more accessible to non-specialist audiences—particularly industry professionals, policymakers, and the media—in order to foster deeper connections between science, regulation, and the NGP industry.

2.Unless otherwise stated, the methods, findings, and conclusions presented in this summary reflect the views of the original paper’s authors. 2Firsts does not endorse any specific position and provides this content solely for informational dissemination.

3.Due to the limitations of our editorial and scientific capacity, there may be inaccuracies or misinterpretations in our summary. We welcome reader feedback and strongly encourage those interested to consult the original paper for a more accurate and comprehensive understanding.

4. 2Firsts supports open discussion and critical thinking around research. While no single study can answer all questions, we believe that open, rational dialogue helps us better understand the world and contributes to the sustainable development of tobacco harm reduction—ultimately enabling consumers to make healthier choices.

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