Prevalence and associated factors of adolescent tobacco use in Kingdom of Saudi Arabia: Findings from nationwide survey.

Tobacco use remains a critical public health issue in Saudi Arabia, where tobacco-related illnesses are a leading cause of preventable mortality. This study assessed the prevalence and associated factors of tobacco use among Saudi adolescents using data from the 2022 Global Youth Tobacco Survey (GYTS). A total of 5,610 students aged 13-15 years were analyzed. The overall tobacco use prevalence was 12.8% (n = 682), with higher rates among older adolescents and males. The main adjusted factors associated with current tobacco use were: male sex (adjusted OR = 1.531, 95% CI: 1.298-1.806, p < 0.001); having close friends who smoke tobacco, compared with none of them smoking (some of them: adjusted OR = 3.553, 95% CI: 2.892-4.363, p < 0.001; most of them: adjusted OR = 3.740, 95% CI: 2.597-5.386, p < 0.001; all of them: adjusted OR = 12.235, 95% CI: 6.951-21.534, p < 0.001); and perceiving tobacco use as "more attractive" (adjusted OR = 1.399, 95% CI: 1.090-1.795, p = 0.008), whereas perceiving tobacco use as "less attractive" was associated with lower odds (adjusted OR = 0.686, 95% CI: 0.563-0.836, p < 0.001). These findings highlight the need for targeted interventions such as school-based prevention programs, parental education initiatives, peer-led anti-tobacco activities, and campaigns by health authorities, including the Public Health Authority (Weqaya), to correct misconceptions about the social appeal of tobacco use and strengthen tobacco control efforts among youth in Saudi Arabia.