Abstract
BACKGROUND: Tobacco use among youth is a critical public health concern, particularly in Saudi Arabia, where a significant youth demographic and evolving tobacco control policies shape usage patterns. The Global Youth Tobacco Survey (GYTS) provides standardized data to monitor these trends, offering insights for dental public health and tobacco cessation counseling. This study analyzes GYTS data from 2001 to 2022 to evaluate trends in youth tobacco use, their association with tobacco control policy implementation, and implications for oral health interventions. MATERIALS AND METHODS: Data from the GYTS conducted in Saudi Arabia (2001, 2007, 2010, and 2022) among youth aged 13-15 years (n = 1,830-4,526) were analyzed. Key indicators included current cigarette smoking, environmental tobacco smoke exposure, cessation attempts, and knowledge/attitudes toward smoking. Descriptive statistics, percent change calculations, linear and joinpoint regression analyses, and gender-specific comparisons assessed trends and policy impacts. Prediction models forecast the prevalence to 2030. Statistical analyses were performed using Python (version 3.10; Python Software Foundation, Wilmington, DE) and the Joinpoint Regression Program (version 4.9.1.0; National Cancer Institute, Bethesda, MD). RESULTS: Current cigarette smoking increased from 4.7% (2001) to 8.9% (2010) before declining to 2.9% (2022), a 38.3% relative decrease. Joinpoint analysis identified a significant trend reversal after 2010, coinciding with comprehensive MPOWER policy implementation (p < 0.001). Boys exhibited higher smoking prevalence than girls, but the gender gap narrowed from 4.0 to 1.3 percentage points (2001-2022). Environmental tobacco smoke exposure and living with smokers decreased by 28.8% and 33.0%, respectively. Cessation indicators showed declines in desire (74.0%-64.9%) and attempts to quit (69.3%-58.7%). Support for smoking bans rose by 14.6%. Predictions suggest smoking prevalence may approach 1.0%-2.0% by 2030 if trends persist. CONCLUSION: Comprehensive tobacco control policies after 2010 significantly reduced youth tobacco use in Saudi Arabia, with notable declines in smoking prevalence and environmental exposure. However, declining cessation indicators highlight the need for targeted interventions. Dental professionals can leverage these trends to integrate cessation counseling into routine care, enhancing oral health outcomes. Sustained policy enforcement and gender-sensitive strategies are crucial to further reduce youth tobacco use by 2030.