Two Saudi surveys find vaping widespread and tied to how users see it

Two cross-sectional surveys published in mid-2026 put figures on vaping in Saudi Arabia, one from the country's south and one from its east, and together they sketch a habit that is common across age groups and bound up with how users perceive the products [s1][s2].

The southern survey

The first study surveyed residents aged 13 and older in Jazan and Aseer, in southern Saudi Arabia, recruiting 1,305 participants online through social media [s1]. The mean age was 24.53 years, and 67.7% of respondents were female [s1].

Overall, 34.0% of participants were ever or current vapers [s1]. Prevalence peaked at ages 28 to 32, at 50.5%, and was lowest among 13-to-17-year-olds, at 11.7%, and those aged 38 and older, at 19.9% [s1].

The study's central finding is about perception rather than knowledge. Most participants had good knowledge of vaping, at 75.8%, and most held negative perceptions of it, at 59.2% [s1]. Knowledge level was not associated with whether someone vaped, with a p-value of 0.418 [s1]. Perception was strongly associated: 90.0% of those with positive perceptions and 75.1% of those with neutral perceptions were vapers, against 5.1% of those with negative perceptions, at a p-value below 0.001 [s1]. In adjusted analysis, vaping was independently associated with male sex, at an odds ratio of 4.42, and with the 28-to-32 age band, at an odds ratio of 7.01 [s1].

The questionnaire was an Arabic instrument adapted from a US Centers for Disease Control and Prevention vaping tool, and it assessed knowledge, perceptions and practices together — a combination the authors note is rarely measured in one study with multivariable predictors [s1]. That design is what allowed the study to separate the effect of knowledge from the effect of attitude, and to find that the two pull in opposite directions.

Because recruitment was an online convenience sample skewed toward women, the prevalence figures should not be read as a population estimate for the region [s1]. The value of the study is in the association it isolates: what people think about vaping tracks with use far more closely than what they know about it [s1].

The eastern survey

The second study surveyed adults in the Eastern Province between December 2024 and February 2025, again online, with 551 participants [s2]. It reported 29.9% as current smokers [s2].

Cigarettes were the most-used product, at 50.7%, followed by shisha at 42.2% and e-cigarettes at 34.5% [s2]. The study documented early initiation: more than half of smokers, 52.7%, started between ages 15 and 20, and 8.5% before age 15 [s2]. Use patterns were mixed, with 26% reporting cigarette-only use, 13% e-cigarette-only use and 32% shisha-only use, alongside dual-use combinations [s2].

The early-initiation finding is the one with the longest reach. When more than half of smokers begin between ages 15 and 20, and a further tranche before 15, the window in which prevention would have to act closes well before adulthood [s2]. The eastern survey's picture of overlapping products — cigarettes, shisha and e-cigarettes each used by a substantial share, with dual and single-product patterns side by side — also complicates the common assumption that vaping simply substitutes for smoking [s2]. In this sample the products coexist rather than displace one another.

What the two surveys establish, and what they don't

Both are cross-sectional online surveys using convenience sampling, which means neither can support a firm national prevalence estimate or establish cause and effect [s1][s2]. Self-reported behaviour can also understate a stigmatised habit. What they do show, consistently, is that e-cigarette use registers alongside long-established products — cigarettes and shisha — rather than replacing them, and that a substantial share of use begins in adolescence [s1][s2].

The perception finding in the southern study is the more actionable of the two: if attitudes are what most closely track use, then knowledge campaigns that assume information alone will deter uptake may be aiming at the wrong target [s1]. Both studies also draw on regions rather than the whole country — the south in one, the east in the other — so they are best read as consistent local snapshots rather than a single national estimate [s1][s2]. This is a description of survey associations, not health advice, and neither study evaluated any intervention [s1][s2].

Sources

• [s1] "Perceptions and Vaping Use among Adolescents and Adults in Southern Saudi Arabia: A Cross-Sectional Survey," Journal of Community Health, 20 August 2026. https://doi.org/10.1007/s10900-026-01625-3
• [s2] "Early Initiation and Dual Patterns of Cigarette and E-Cigarette Use among Adults in the Eastern Province, Saudi Arabia," Saudi Medical Journal, 6 July 2026. https://doi.org/10.15537/1658-3175.8825