Prevalence, perception, and attitude regarding electronic cigarettes usage among young adults in Riyadh, Saudi Arabia. A cross-sectional study

Norah I. AlHumaidan; Lama A. AlZelfawi; Zeena A. AlHindawi; Lena M. AlDosari; Aljoharah M. AlTowaijri; Njoud F. AlFaisal

doi:10.15537/smj.2024.45.8.20240359

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Table 1

- Demographic factors of the participants.

Variables	n (%)
Age (year), mean±SD	21.29±2.37
Gender
Male	98 (20.6)
Female	378 (79.4)
Nationality
Saudi	451 (94.7)
Non-Saudi	25 (5.3)
Monthly income
<5000 SR	42 (8.8)
5000-10000 SR	102 (21.4)
>10000 SR	237 (49.8)
I do not know	95 (20.0)
Work
Not working but searching for work	38 (8.0)
Not working and not searching for work	8 (1.7)
Housewife	10 (2.1)
Students	336 (70.6)
Employee	81 (17.0)
In military	3 (0.6)
Marital status
Single	413 (86.8)
Married	60 (12.6)
Divorced	3 (0.6)
Parent’s marital status
Married	404 (84.9)
Divorced	26 (5.5)
One of them has died	35 (7.4)
Both have died	11 (2.3)
Living with:
Parents	439 (92.2)
Alone	32 (6.7)
With a friend	5 (1.1)
Current use of e-cigarettes
Yes, only e-cigarette	38 (8.0)
Yes, in addition to regular cigarette	12 (2.5)
No, but use them once	46 (9.7)
No, and never used them	380 (79.8)
Use of e-cigarette^*
No	380 (79.8)
Yes	96 (20.2)
Do any of your friends or family members use e-cigarettes?
No	199 (41.8)
Yes	245 (51.5)
I do not know	32 (6.7)
Are there any smokers in your accommodation?
No	234 (49.2)
Yes	209 (43.9)
Not sure	33 (6.9)

Values are presented as numbers and percentages (%).

E-cigarette: electronic cigarette, SD: standard deviation, SR: Saudi Riyals

↵* People who have used electronic cigarettes at any time in their lives.

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Table 2

- Perceptions, practices, and attitudes of participants toward electronic cigarettes.

Variables	n (%)
Perception of participants regarding e-cigarettes
Do you believe that using e-cigarettes instead of nicotine gum or patches is a safer approach to stop smoking?
No	338 (71.0)
Yes	51 (10.7)
Not sure	87 (18.3)
Do you think that using e-cigarettes is safer than regular cigarettes (traditional tobacco cigarettes)?
No	330 (69.3)
Yes	90 (18.9)
Not sure	56 (11.8)
Do you think that the preservatives or flavors used in e-cigarettes are harmless?
No	388 (81.5)
Yes	40 (8.4)
Not sure	48 (10.1)
Do you think that exposing children to e-cigarette smoke is safe?
No	438 (92.0)
Yes	14 (2.9)
Not sure	24 (5.0)
Does using e-cigarettes indoors cause harm to nonsmokers in the same space (passive smoking) if exposed to the air emitted by e-cigarettes?
No	58 (12.2)
Yes	359 (75.4)
Not sure	59 (12.4)
Are you aware of a legal minimum age for using e-cigarettes?
No minimum age to use e-cigarettes	43 (9.0)
At least 18 years	148 (31.1)
At least 21 years	80 (16.8)
Prohibited for all ages	115 (24.2)
Unsure	90 (18.9)
Practice and attitude of participants toward e-cigarettes
How frequently do you use e-cigarettes?
Do not use them	401 (84.2)
Once daily	5 (1.1)
More than once daily	39 (8.2)
1-2 times weekly	11 (2.3)
1-2 times monthly	20 (4.2)
Where do you buy electronic cigarettes?
Do not use them	395 (83.0)
Shops selling electronic cigarettes	42 (8.8)
Grocery store	8 (1.7)
Tobacco and shisha shops	23 (4.8)
Friends	8 (1.7)
Do you trust the nicotine concentration value written on the product label?
Do not use e-cigarettes	364 (76.5)
No, I do not trust them	49 (10.3)
Yes, I trust them	40 (8.4)
I use nicotine-free e-cigarettes	4 (0.8)
Unsure	19 (4.0)
Where do you use electronic cigarettes?
Do not use e-cigarettes	393 (82.6)
In indoor spaces	10 (2.1)
In outdoor spaces	17 (3.6)
Both in- and outdoor spaces	56 (11.8)
Are you ready to quit using e-cigarettes?
Do not use e-cigarettes	397 (83.4)
No	14 (2.9)
Yes, at the earliest time	29 (6.1)
Yes, in future	30 (6.3)
Not sure	6 (1.3)
What do you think regarding using electronic cigarettes?
Not harmful	16 (3.4)
Less harmful than normal cigarettes	64 (13.4)
Same harm as normal cigarettes	169 (35.5)
More harmful than normal cigarettes	180 (37.8)
Not sure	47 (9.9)

Values are presented as numbers and percentages (%). E-cigarette: electronic cigarette

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Table 3

- Factors affecting the prevalence of e-cigarette usage.

Variables	Use of e-cigarette		Chi-t test	Fisher’s exact	Regression model
Variables	No	Yes	Chi-t test	Fisher’s exact	RR	95% CI	P-values
Gender
Male	52 (53.1)	46 (46.9)	<0.001*	<0.001*	5.80	3.53-9.53	<0.001*
Female	328 (86.8)	50 (13.2)	<0.001*	<0.001*	Ref.
Nationality
Saudi	367 (81.4)	84 (18.6)	<0.001*	0.001*	0.386	0.14-1.03	0.060
Non-Saudi	13 (52.0)	12 (48.0)	<0.001*	0.001*	Ref.
Monthly income
I do not know	79 (83.2)	16 (16.8)	0.805	0.811	Ref.
<5000 SR	33 (78.6)	9 (21.4)			0.94	0.31-2.89	0.926
5000-10000 SR	82 (80.4)	20 (19.6)			0.69	0.28-1.70	0.425
>10000 SR	186 (78.5)	51 (21.5)			1.18	0.57-2.44	0.654
Marital status
Single	325 (78.7)	88 (21.3)	0.187	0.130	Ref.
Married	53 (88.3)	7 (11.7)			0.487	0.21-1.11	0.087
Divorced	2 (66.7)	1 (33.3)			1.846	0.16-20.6	0.618
Marital status of parents
Married	322 (79.7)	82 (20.3)	0.333	0.390	Ref.
Divorced	18 (69.2)	8 (30.8)			1.745	0.733-4.155	0.208
One of them has died	30 (85.7)	5 (14.3)			0.654	0.24-1.74	0.395
Both have died	10 (90.9)	1 (9.1)			0.393	0.04-3.11	0.376
Living with:
Parents	358 (81.5)	81 (18.5)	<0.001*	<0.001*	Ref.
`Alone	21 (65.6)	11 (34.4)			2.315	1.07-4.99	0.032*
With a friend	1 (20.0)	4 (80.0)			17.67	1.94-160.28	0.010*
Do any of your friends or family members use e-cigarettes?
No	186 (93.5)	13 (6.5)	<0.001*	<0.001*	Ref.
Yes	164 (66.9)	81 (33.1)			7.066	3.79-13.16	0.000*
Not know	30 (93.8)	2 (6.3)			0.954	0.204-4.43	0.952
Are there any smokers in your accommodation?
No	199 (85.0)	35 (15.0)	0.003*	0.003*	Ref.
Yes	152 (72.7)	57 (27.3)			2.13	1.33-3.41	0.002*
Not sure	29 (87.9)	4 (12.1)			0.784	0.259-2.368	0.666

Values are presented as numbers and percentages (%). CI: confidence interval, RR: relative risk, e-cigarette: electronic cigarettes, Ref.: reference, SR: Saudi Riyals