{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:35:54Z","timestamp":1793392554779,"version":"4.5.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Tobacco use is a major global public health challenge, causing millions of deaths annually. In Saudi Arabia, increasing adult smoking rates highlight the need for improved tobacco control measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study examined trends in tobacco use among youth in Saudi Arabia from 2007 to 2022, evaluating shifts in the determinants of tobacco use and the effectiveness of control measures over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed three waves of the Global Youth Tobacco Survey (GYTS) conducted in Saudi Arabia (2007, <jats:italic>n<\/jats:italic>\u202f=\u202f2,574; 2010, <jats:italic>n<\/jats:italic>\u202f=\u202f1,797; 2022, <jats:italic>n<\/jats:italic>\u202f=\u202f5,610). The GYTS uses a two-stage cluster sampling design to select students aged 13\u201315 from intermediate schools, with a focus on tobacco use trends and related behaviors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study revealed a substantial decline in current tobacco product usage, dropping significantly from 15.9% in 2007 to 9.4% in 2022 (<jats:italic>B<\/jats:italic>\u202f=\u202f\u22120.44, <jats:italic>p<\/jats:italic>\u202f=\u202f0.030), and a decrease in exposure to second-hand smoke from 27.9% in 2007 to 18.1% in 2022. However, the proportion of individuals aged 7\u202fyears or younger who initiated cigarette smoking rose from 9.1% in 2007 to 17.1% in 2022. There was a 6.4% increase among female youth who thought that smoking made people feel comfortable across this time period (<jats:italic>B<\/jats:italic>\u202f=\u202f0.55, <jats:italic>p<\/jats:italic>\u202f=\u202f0.033), and this population demonstrated a significant decrease in the intention to quit smoking from 65.7 to 52.2% (<jats:italic>B<\/jats:italic>\u202f=\u202f\u22120.895, <jats:italic>p<\/jats:italic>\u202f=\u202f0.010).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although overall tobacco use decreased, alarming trends, emerged, such as earlier smoking initiation and declining intentions to quit among females. Future interventions should focus on preventing early tobacco use initiation by addressing misconceptions, promoting cessation, and enforcing restrictions on youth access to tobacco products.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1608394","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:51:58Z","timestamp":1751435518000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Tobacco use trends among youth in Saudi Arabia: 2007\u20132022"],"prefix":"10.3389","volume":"13","author":[{"given":"Sarah S.","family":"Monshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman D. El","family":"Desouky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaikha K.","family":"Aldukhail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmohsen H.","family":"Al-Zalabani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed M.","family":"Alqahtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervat M. El","family":"Dalatony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mosa A.","family":"Shubayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Elkhobby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed S.","family":"Aldossary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"ref1","volume-title":"Global burden of disease database","year":"2019"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"611","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":"ref3","doi-asserted-by":"publisher","first-page":"1 1","DOI":"10.32868\/rsj.v1i1.22","article-title":"The prevalence of cigarette smoking in Saudi Arabia in 2018","volume":"1","author":"Algabbani","year":"2018","journal-title":"Food Drug Regul Sci J"},{"key":"ref4","article-title":"Global Adult Tobacco Survey: Fact Sheet Saudi Arabia 2019","year":"2020"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"858","DOI":"10.26719\/emhj.20.019","article-title":"Combating tobacco use in Saudi Arabia: a review of recent initiatives","volume":"26","author":"Itumalla","year":"2020","journal-title":"East Mediterr Health J"},{"key":"ref6","article-title":"Saudi youth statistics report 2023","year":"2023"},{"key":"ref7","volume-title":"Adolescent health: Understanding and preventing risk behaviors","author":"DiClemente","year":"2009"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e72","DOI":"10.1016\/j.pedn.2022.03.002","article-title":"Systematic review and meta-analysis: prevalence of hypertension among adolescents in the Arab countries","volume":"65","author":"Almahmoud","year":"2022","journal-title":"J Pediatr Nurs"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1155\/ijcp\/7233591","article-title":"Cardiovascular disease management and prevention in Saudi Arabia: strategies, risk factors, and targeted interventions","volume":"2025","author":"Alsaidan","year":"2025","journal-title":"Int J Clin Pract"},{"key":"ref10","article-title":"Discussion draft of sociopolitical strategy","year":"2023"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.18332\/tid\/174900","article-title":"Population-level impact of \u2018the real Cost\u2019campaign on youth smoking risk perceptions and curiosity, united sates 2018\u20132020","volume":"21","author":"Aldukhail","year":"2023","journal-title":"Tob Induc Dis"},{"key":"ref12","article-title":"Tobacco free initiative, Saudi Arabia: Offering help to quit tobacco use","year":"2019"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"867","DOI":"10.15537\/smj.2019.9.24477","article-title":"A systematic review of the prevalence and risk factors of smoking among Saudi adolescents","volume":"40","author":"Alasqah","year":"2019","journal-title":"Saudi Med J"},{"key":"ref14","article-title":"WHO global report on trends in prevalence of tobacco use 2000\u20132030","year":"2024"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.18332\/tid\/197410","article-title":"Electronic cigarette use among adolescents in Saudi Arabia: a national study, 2022","volume":"23","author":"AlDukhail","year":"2025","journal-title":"Tob Induc Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3390\/ijerph17218194","article-title":"Smokers\u2019 and non-smokers\u2019 attitudes towards smoking cessation in Saudi Arabia: a systematic review","volume":"17","author":"Tobaiqy","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref17","article-title":"WHO framework convention on tobacco control. 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