Abstract
INTRODUCTION: Tobacco use among adolescents continues to pose a major public-health challenge in Saudi Arabia. Despite national prevention efforts and declining smoking rates, many youths remain vulnerable to nicotine addiction and experimentation with emerging products such as shisha and e-cigarettes. Understanding factors that influence quit attempts and cessation awareness is essential to guide effective school- and community-based tobacco-control interventions. This study assessed the prevalence of quit attempts and identified behavioral and environmental correlates of cessation motivation among Saudi youth using data from the 2022 Global Youth Tobacco Survey. METHODS: A cross-sectional analysis was conducted using data from 6983 students aged 11-17 years who participated in the 2022 Global Youth Tobacco Survey. Weighted analyses described tobacco-use patterns and cessation behaviors. Chi-squared tests examined bivariate relationships, while multivariable logistic regression identified independent factors associated with quit attempts, including adjusting for age, sex, parental and peer smoking, and media exposure. Significance was defined as p<0.05. RESULTS: Approximately 33% of respondents had ever used tobacco or nicotine, and 10.8% were current users. Among those who used tobacco within the past 12 months (n=411), 77.4% had attempted to quit, 64% wanted to stop, and 79.8% had received advice to quit. Factors associated with quit attempts included having no close friends who smoke (AOR=4.38; 95% CI: 1.73-11.07), exposure to school-based anti-tobacco lessons (AOR=3.25; 95% CI: 1.51-6.99), noticing health warnings on shisha packs (AOR=2.59; 95% CI: 1.02-6.55), and exposure to tobacco imagery in media (AOR=3.19; 95% CI: 1.64-6.17). CONCLUSIONS: Most Saudi youth who use tobacco express a desire to quit, and social context strongly influences their cessation behavior. Reinforcing school-based anti-tobacco education, expanding adolescent cessation programs, and strengthening policy enforcement could further reduce tobacco use and improve cessation outcomes among young people.