{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:04:24Z","timestamp":1790103864208,"version":"4.0.1"},"reference-count":52,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,28]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess the burden of secondhand tobacco smoke (SHS) exposure in the Kingdom of Saudi Arabia by examining its prevalence, awareness levels and associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A large population-based survey was conducted across Saudi Arabia from March 2023 to January 2024 using non-probability sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults (\u226518 years of age) with Saudi nationality and presently residing within the borders of Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Prevalence of SHS and public knowledge and awareness. The factors linked to exposure and lack of awareness of SHS health risks were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10\u2009082 participants were analysed, of whom 53% were female and 62% were aged 18\u201330. The sample included 36% married, 56% living with their children and 49% living with 3\u20134 people in their household. Around 14% of the sample had comorbid conditions, including heart disease, diabetes mellitus and chronic respiratory disease. The prevalence of SHS in our sample was 50% (95% CI 48.9% to 50.9%), with a considerable prevalence at home (57.1% (95% CI 55.8% to 58.5%)) and (16.2% (95% CI 15.2% to 17.2%)) in cafes, coffee stores and tea houses. Most people were exposed to a combination of cigarettes and water pipes (42% (95% CI 40.5% to 43.2%)) and to regular cigarettes (27.4% (95% CI 26.1% to 28.6%)). Nearly 74% of individuals exposed to SHS were unhappy with their exposure. SHS health risks were known by 56% (95% CI 55.5% to 57.4%) of respondents, while 86.5% (95% CI 85.9% to 87.2%) advocated for stronger laws to stop public smoking. Social media (75% (95% CI 74.2% to 76.4%)) and friends and family (57.9% (95% CI 56.6% to 59.3%)) were respondents\u2019 top sources of SHS risk information. An increased risk of SHS exposure was associated with males OR (95%\u2009CI): 1.56 (1.16 to 2.11), e-cigarette use OR (95%\u2009CI): 1.95 (1.33 to 2.92), unemployment OR (95%\u2009CI): 2.30 (1.52 to 3.48) and diploma and secondary school education OR (95%\u2009CI): 4.94 (3.21 to 7.59); 2.10 (1.52 to 2.90), respectively. Lack of awareness of SHS health risks is linked to males OR (95%\u2009CI): 0.41 (0.31 to 0.54), cigarette smokers OR (95%\u2009CI): 0.55 (0.40 to 0.77) and big households (7+ persons) compared with 1\u20132 households OR (95%\u2009CI): 1.70 (1.06 to 2.74).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SHS exposure is prevalent among the Saudi public, particularly in households, among males, e-cigarette smokers and the unemployed. Overall, there is low knowledge and awareness regarding the overall health risks of SHS exposure among the public.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119570","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:35:45Z","timestamp":1790102145000},"page":"e119570","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, predictors and burden of secondhand tobacco smoke (SHS) exposure in Saudi Arabia: a large-scale cross-sectional survey"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1795-5092","authenticated-orcid":false,"given":"Jaber S","family":"Alqahtani","sequence":"first","affiliation":[{"name":"Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia"},{"name":"Research and Innovation Institute, Ministry of Defense Health Services, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albandari","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Respiratory Care Department, Northern Area Armed Forces Hospital, Hafar Al Batin, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manar","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Respiratory Care Department, Al Hada Military Hospital, Taif, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razan","family":"Mubarak","sequence":"additional","affiliation":[{"name":"Respiratory Care Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouq","family":"Khalid","sequence":"additional","affiliation":[{"name":"Respiratory Care Department, Prince Sultan Cardic Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4270-9494","authenticated-orcid":false,"given":"Abdulelah M","family":"Aldhahir","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Program, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayan A","family":"Siraj","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Department, King Faisal University, Al-Ahsa, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-3901","authenticated-orcid":false,"given":"Abdullah A","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-1110","authenticated-orcid":false,"given":"Saeed M","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim A","family":"AlDraiwiesh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam M","family":"Almarkhan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah A","family":"Ghazwani","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8440-7446","authenticated-orcid":false,"given":"Abdallah Y","family":"Naser","sequence":"additional","affiliation":[{"name":"Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Isra University, Amman, Jordan"},{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy, Ataturk University, Erzurum, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Alwafi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nowaf Y","family":"Alobaidi","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Department, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Alahsa, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M","family":"Hjazi","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duaa","family":"AlSubait","sequence":"additional","affiliation":[{"name":"Scientific Research and Publication Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zechariah","family":"Arulanantham","sequence":"additional","affiliation":[{"name":"Scientific Research and Publication Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mushabbab A","family":"Alahmari","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, Faculty of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia"},{"name":"Health and Humanities Research Center, University of Bisha, Bisha, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed M","family":"Alyami","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turki M","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Department, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Alahsa, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"AlBahrani","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia"},{"name":"Imam Abdulrahman Bin Faisal University College of Medicine, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1151-0295","authenticated-orcid":false,"given":"Tope","family":"Oyelade","sequence":"additional","affiliation":[{"name":"School of Medicine, Keele University, Keele, UK"},{"name":"Division of Medicine, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026092211353692000_16.9.e119570.1","first-page":"1","article-title":"Tobacco smoke and involuntary smoking","volume":"83","year":"2004","journal-title":"IARC Monogr Eval Carcinog Risks Hum"},{"key":"2026092211353692000_16.9.e119570.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2002.00993.x"},{"key":"2026092211353692000_16.9.e119570.3","doi-asserted-by":"crossref","unstructured":"Alqahtani JS , Aldhahir AM , Siraj RA , et al . A nationwide survey of public COPD knowledge and awareness in Saudi Arabia: A population-based survey of 15,000 adults. PLoS ONE 2023;18. doi:10.1371\/journal.pone.0287565","DOI":"10.1371\/journal.pone.0287565"},{"key":"2026092211353692000_16.9.e119570.4","unstructured":"Organization WH, Initiative TF . Protection from exposure to second-hand smoke: Policy recommendations. World Health Organization, 2007."},{"key":"2026092211353692000_16.9.e119570.5","unstructured":"Organization WH . Tobacco free initiative. 2024. Available: https:\/\/www.emro.who.int\/tfi\/quit-now\/secondhand-smoke-impacts-health.html"},{"key":"2026092211353692000_16.9.e119570.6","unstructured":"Prevention CfDCa . Health problems caused by secondhand smoke. 2022. Available: https:\/\/www.cdc.gov\/tobacco\/secondhand-smoke\/health.html"},{"key":"2026092211353692000_16.9.e119570.7","first-page":"375","article-title":"Lung Cancer in Non-Smokers","volume":"117","author":"Dubin","year":"2020","journal-title":"Mo Med"},{"key":"2026092211353692000_16.9.e119570.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199306103282303"},{"key":"2026092211353692000_16.9.e119570.9","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1164\/ajrccm\/145.3.594","article-title":"Childhood asthma and passive smoking. Urinary cotinine as a biomarker of exposure","volume":"145","author":"Ehrlich","year":"1992","journal-title":"Am Rev Respir Dis"},{"key":"2026092211353692000_16.9.e119570.10","doi-asserted-by":"publisher","DOI":"10.1136\/thx.49.8.731"},{"key":"2026092211353692000_16.9.e119570.11","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e328343165d"},{"key":"2026092211353692000_16.9.e119570.12","unstructured":"World Health Organization . WHO framework convention on tobacco control. World Health Organization; 2003."},{"key":"2026092211353692000_16.9.e119570.13","doi-asserted-by":"crossref","first-page":"105833","DOI":"10.1016\/j.ypmed.2019.105833","article-title":"Burden of disease attributable to second-hand smoke exposure: A systematic review","volume":"129","author":"Carreras","year":"2019","journal-title":"Prev Med"},{"key":"2026092211353692000_16.9.e119570.14","doi-asserted-by":"publisher","DOI":"10.26719\/emhj.20.019"},{"key":"2026092211353692000_16.9.e119570.15","first-page":"V","article-title":"Emerging Trend of Waterpipe use in Saudi Arabia","volume":"5","author":"Naeem","year":"2011","journal-title":"Int J Health Sci (Qassim)"},{"key":"2026092211353692000_16.9.e119570.16","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2024.1295847","article-title":"A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia","volume":"14","author":"AlRabeeah","year":"2024","journal-title":"Front Oncol"},{"key":"2026092211353692000_16.9.e119570.17","doi-asserted-by":"crossref","first-page":"88","DOI":"10.18332\/tid\/128317","article-title":"Levels and factors of knowledge about the related health risks of exposure to secondhand smoke among medical students: A cross-sectional study in Jeddah, Saudi Arabia","volume":"18","author":"Alzahrani","year":"2020","journal-title":"Tob Induc Dis"},{"key":"2026092211353692000_16.9.e119570.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-1902-3","article-title":"Tobacco consumption in the Kingdom of Saudi Arabia, 2013: findings from a national survey","volume":"15","author":"Moradi-Lakeh","year":"2015","journal-title":"BMC Public Health"},{"key":"2026092211353692000_16.9.e119570.19","doi-asserted-by":"crossref","unstructured":"Algabbani A , Bin Dhim N . Passive smoking and knowledge of its health hazards in the Kingdom of Saudi Arabia. Eur J Public Health 2020;30. doi:10.1093\/eurpub\/ckaa165.1362","DOI":"10.1093\/eurpub\/ckaa165.1362"},{"key":"2026092211353692000_16.9.e119570.20","unstructured":"Institute NC . Secondhand smoke and cancer. 2018. Available: https:\/\/www.cancer.gov\/about-cancer\/causes-prevention\/risk\/tobacco\/second-hand-smoke-fact-sheet [Accessed 7 Mar 2024]."},{"key":"2026092211353692000_16.9.e119570.21","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-019524","article-title":"Prevalence and factors associated with exposure to secondhand smoke (SHS) among young people: a cross-sectional study from the Gambia","volume":"8","author":"Jallow","year":"2018","journal-title":"BMJ Open"},{"key":"2026092211353692000_16.9.e119570.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0210981","article-title":"Secondhand smoke knowledge, sources of information, and associated factors among hospital staff","volume":"14","author":"Lee","year":"2019","journal-title":"PLoS ONE"},{"key":"2026092211353692000_16.9.e119570.23","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291798006667"},{"key":"2026092211353692000_16.9.e119570.24","first-page":"1","article-title":"Designing and validation of questionnaire","volume":"2","author":"Jain","year":"2016","journal-title":"IDJAR"},{"key":"2026092211353692000_16.9.e119570.25","doi-asserted-by":"crossref","first-page":"e1667","DOI":"10.1016\/S2214-109X(21)00365-X","article-title":"Global trends in the prevalence of secondhand smoke exposure among adolescents aged 12-16 years from 1999 to 2018: an analysis of repeated cross-sectional surveys","volume":"9","author":"Ma","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2026092211353692000_16.9.e119570.26","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0140-6736(10)61388-8","article-title":"Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries","volume":"377","author":"\u00d6berg","year":"2011","journal-title":"The Lancet"},{"key":"2026092211353692000_16.9.e119570.27","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-018-5549-8","article-title":"The prevalence of smoking, second-hand smoke exposure, and knowledge of the health hazards of smoking among internal migrants in 12 provinces in China: a cross-sectional analysis","volume":"18","author":"Zheng","year":"2018","journal-title":"BMC Public Health"},{"key":"2026092211353692000_16.9.e119570.28","doi-asserted-by":"crossref","first-page":"19","DOI":"10.37231\/ajmb.2021.5.1.411","article-title":"The Prevalence of Secondhand Smoke and Its Associated Factors among Adults Residing in the Low Income Residence, Kuala Terengganu, Malaysia","volume":"5","author":"Munira Mat Azmi","year":"2021","journal-title":"AJMB"},{"key":"2026092211353692000_16.9.e119570.29","first-page":"263","article-title":"Second-hand smoke exposure in Canada: prevalence, risk factors, and association with respiratory and cardiovascular diseases","volume":"15","author":"Vozoris","year":"2008","journal-title":"Can Respir J"},{"key":"2026092211353692000_16.9.e119570.30","article-title":"Second-Hand Smoking Prevalence in Vietnamese Population Aged 15 and older: A Systematic Review and Meta-Analysis","volume":"16","author":"Duc","year":"2022","journal-title":"Subst Abuse"},{"key":"2026092211353692000_16.9.e119570.31","article-title":"Association Between Second-Hand Smoke Exposure and Respiratory Symptoms Among the General Population of Non-smoker Adults in Saudi Arabia: A Cross-Sectional Study","volume":"15","author":"Madkhali","year":"2023","journal-title":"Cureus"},{"key":"2026092211353692000_16.9.e119570.32","doi-asserted-by":"crossref","DOI":"10.1016\/j.chest.2023.07.4112","article-title":"Prevalence of second-hand smoke among the general public in saudi arabia: An interim result","volume":"164","author":"Alqarni","year":"2023","journal-title":"Chest"},{"key":"2026092211353692000_16.9.e119570.33","unstructured":"MoHiSA G . The executive regulations of anti-smoking law. Makkah, Saudi Arabia: Ministry of Health in Saudi Arabia Government, 2019."},{"key":"2026092211353692000_16.9.e119570.34","unstructured":"Organization WH . WHO report on the global tobacco epidemic, 2023: protect people from tobacco smoke. 2023."},{"key":"2026092211353692000_16.9.e119570.35","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2147\/SAR.S393062","article-title":"Impact of Smoking Status and Nicotine Dependence on Academic Performance of Health Sciences Students","volume":"14","author":"Alqahtani","year":"2023","journal-title":"Subst Abuse Rehabil"},{"key":"2026092211353692000_16.9.e119570.36","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2019.9.24477"},{"key":"2026092211353692000_16.9.e119570.37","first-page":"15","article-title":"Global Tobacco Surveillance System (GTSS): purpose, production, and potential. - Fact Sheets for Eastern Mediterranean (EMR) Region, Saudi Arabia","volume":"75","year":"2019","journal-title":"Saudi Arabia - National The Journal of School Health"},{"key":"2026092211353692000_16.9.e119570.38","doi-asserted-by":"publisher","DOI":"10.1111\/add.12623"},{"key":"2026092211353692000_16.9.e119570.39","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i4645","article-title":"Association between electronic cigarette use and changes in quit attempts, success of quit attempts, use of smoking cessation pharmacotherapy, and use of stop smoking services in England: time series analysis of population trends","volume":"354","author":"Beard","year":"2016","journal-title":"BMJ"},{"key":"2026092211353692000_16.9.e119570.40","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-036055","article-title":"Is dual use of nicotine products and cigarettes associated with smoking reduction and cessation behaviours? A prospective study in England","volume":"10","author":"Jackson","year":"2020","journal-title":"BMJ Open"},{"key":"2026092211353692000_16.9.e119570.41","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056901"},{"key":"2026092211353692000_16.9.e119570.42","doi-asserted-by":"crossref","DOI":"10.18332\/tid\/131624","article-title":"The effect of e-cigarettes on smoking cessation and cigarette smoking initiation: An evidence-based rapid review and meta-analysis","volume":"19","author":"Zhang","year":"2021","journal-title":"Tob Induc Dis"},{"key":"2026092211353692000_16.9.e119570.43","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/eurpub\/ckr202","article-title":"Comprehensive smoke-free policies attract more support from smokers in Europe than partial policies","volume":"22 Suppl 1","author":"Mons","year":"2012","journal-title":"Eur J Public Health"},{"key":"2026092211353692000_16.9.e119570.44","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1177\/030089160809400604","article-title":"Prevalence of second-hand smoke exposure after introduction of the Italian smoking ban: the Florence and Belluno survey","volume":"94","author":"Gorini","year":"2008","journal-title":"Tumori"},{"key":"2026092211353692000_16.9.e119570.45","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph10062370"},{"key":"2026092211353692000_16.9.e119570.46","first-page":"21","article-title":"Second-Hand Smoke in a University Campus: Attitudes and Perceptions of Faculty, Staff and Students","volume":"4","author":"Mishra","year":"2011","journal-title":"Int J Health Res"},{"key":"2026092211353692000_16.9.e119570.47","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/2010105817747627","article-title":"Factors associated with second-hand smoke awareness in Malaysia","volume":"27","author":"Cheah","year":"2018","journal-title":"Proceedings of Singapore Healthcare"},{"key":"2026092211353692000_16.9.e119570.48","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1515\/ijamh-2019-0014","article-title":"Prevalence and factors related to second hand smoking exposure, knowledge and response among adolescents in rural Puducherry","volume":"33","author":"Arikrishnan","year":"2020","journal-title":"Int J Adolesc Med Health"},{"key":"2026092211353692000_16.9.e119570.49","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18115665","article-title":"Socioeconomic Determinants of Smoking in the Kingdom of Saudi Arabia","volume":"18","author":"Qattan","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026092211353692000_16.9.e119570.50","doi-asserted-by":"crossref","first-page":"1904870","DOI":"10.3389\/fpubh.2026.1904870","article-title":"Status of COPD in Saudi Arabia: challenges, gaps, and opportunities for health system transformation","volume":"14","author":"Alqahtani","year":"2026","journal-title":"Front Public Health"},{"key":"2026092211353692000_16.9.e119570.51","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0268772","article-title":"Prevalence, incidence, morbidity and mortality rates of COPD in Saudi Arabia: Trends in burden of COPD from 1990 to 2019","volume":"17","author":"Alqahtani","year":"2022","journal-title":"PLoS One"},{"key":"2026092211353692000_16.9.e119570.52","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-024-03274-5","article-title":"Prevalence and predictors of polypharmacy and comorbidities among patients with chronic obstructive pulmonary disease: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia","volume":"24","author":"Alwafi","year":"2024","journal-title":"BMC Pulm Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-119570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:35:52Z","timestamp":1790102152000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-119570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":52,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,22]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bmjopen-2026-119570"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-119570","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}