Electronic cigarette use among adolescents in Saudi Arabia: A national study, 2022

Electronic cigarette (e-cigarette) use has increased globally among adolescents. However, data on its use among adolescents in Saudi Arabia remain limited. Therefore, this study describes the characteristics and factors associated with e-cigarette use in this population. Data from the Saudi Arabia 2022 Global Youth Tobacco Survey targeting students aged 13-15 years were analyzed. This study examined current use and ever use of e-cigarettes as dependent variables, and sociodemographic characteristics, smoking behaviors, and exposure to tobacco-related messages as independent variables. Among the adolescents, 14.2% had ever used e-cigarettes, while 5.3% were current users. Older adolescents exhibited a higher prevalence of ever use (12%, 13%, and 19% among those aged 13, 14, and 15 years, respectively). Of those who ever smoked cigarettes, 44% reported ever using e-cigarettes, and 23% were current users. Older adolescents (15 years) were 35% more likely to be ever e-cigarette users (AOR=1.35; 95% CI: 1.32-1.38) and 39% more likely to be current e-cigarette users (AOR=1.39; 95% CI: 1.34-1.43) than those aged 13 years. Exposure to pro-tobacco marketing was associated with twice the odds of ever using e-cigarettes (AOR=2.23; 95% CI: 2.21-2.26) and 2.76 times the odds of becoming current e-cigarette users (AOR=2.64; 95% CI: 2.58-2.69) compared with non-exposed adolescents. E-cigarette use is more prevalent among older adolescents, males, and those with higher weekly allowances. Additionally, e-cigarette use is associated with adolescents who use tobacco cigarettes, are exposed to secondhand smoke, or encounter tobacco promotional marketing.