{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:48:52Z","timestamp":1792144132080,"version":"4.4.0"},"reference-count":0,"publisher":"Armed Forces Medical Services","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Saudi Medical Journal"],"abstract":"<jats:p>Objectives: To explore the early initiation of cigarette and e-cigarette use and the dual patterns of usage among adults in the Eastern Province of Saudi Arabia. Methods: A cross-sectional survey was conducted from December 2024 to February 2025 among adults living in the Eastern Province. An online self-administered questionnaire collected data on sociodemographic characteristics, smoking behaviors, age of initiation, dual-use patterns, and quit attempts. Convenience sampling was applied, and a total of 551 participants were included. Descriptive statistics summarized distributions of smoking behavior and initiation age. Pearson's Chi-square tests were used to examine associations between smoking status, age of initiation, and product-use categories. Results: Among the 551 participants, 29.9% were current smokers. Cigarettes were the most used product (50.7%), followed by shisha (42.2%) and e-cigarettes (34.5%). More than half of smokers (52.7%) initiated smoking between 15\u201320 years of age, while 8.5% initiated before age 15. Tobacco-use patterns varied, with 26% reporting cigarette-only use, 13% e-cigarette-only use, and 32% shisha-only use. Dual-use patterns included cigarette + shisha (7%), cigarette + e-cigarette (6%), and e-cigarette + shisha (5%), while 11% reported triple-product use. Quit attempts were most common among cigarette-only users (42 attempts), followed by e-cigarette\u2013only users (22) and dual users (14). Conclusion: Early initiation and diverse tobacco-use patterns including cigarette, shisha, and e-cigarette use are common in the Eastern Province. Dual and triple-product use further highlight evolving nicotine behaviors, emphasizing the need for targeted prevention and cessation strategies.<\/jats:p>","DOI":"10.15537\/1658-3175.8825","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T21:20:45Z","timestamp":1783632045000},"page":"1334-1342","source":"Crossref","is-referenced-by-count":0,"title":["Early Initiation and Dual Patterns of Cigarette and E-Cigarette Use among Adults in the Eastern Province, Saudi Arabia: &lt;i&gt;A Cross-Sectional Study&lt;\/i&gt;"],"prefix":"10.15537","volume":"47","author":[{"given":"Haidar A.","family":"AlRidha","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora A.","family":"Alafif","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56029","published-online":{"date-parts":[[2026,7,6]]},"container-title":["Saudi Medical Journal"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:26:14Z","timestamp":1792142774000},"score":1,"resource":{"primary":{"URL":"https:\/\/smj.researchcommons.org\/journal\/vol47\/iss8\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":0,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,7,6]]}},"URL":"https:\/\/doi.org\/10.15537\/1658-3175.8825","relation":{},"ISSN":["1658-3175"],"issn-type":[{"value":"1658-3175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}