--- title: "Prevalence and predictors of secondhand smoke exposure in Saudi Arabia: findings from a large nati" id: "bmj-open-10-prevalence-predictors-and-burden-of-secondhand-tobacco-smoke-shs-exposure-in" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-10-prevalence-predictors-and-burden-of-secondhand-tobacco-smoke-shs-exposure-in" content_type: "clinical_feed_article" specialty: "Pulmonology" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e119570?rss=1" published_at: "2026-09-22T17:11:09.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Prevalence and predictors of secondhand smoke exposure in Saudi Arabia: findings from a large nati ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-10-prevalence-predictors-and-burden-of-secondhand-tobacco-smoke-shs-exposure-in - **Specialty:** [Pulmonology](https://medichelpline.com/clinical-feed/pulmonology.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e119570?rss=1) - **Published At:** 2026-09-22T17:11:09.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - A cross-sectional, population-based survey in Saudi Arabia (March 2023–January 2024) analysed 10,082 adult Saudi residents to assess **secondhand tobacco smoke (SHS)** prevalence, awareness, and associated factors. - Overall SHS prevalence in the sample was 50% (95% CI 48.9%–50.9%). Home was the most common exposure setting (57.1%, 95% CI 55.8%–58.5%), with cafes, coffee stores and tea houses accounting for 16.2% (95% CI 15.2%–17.2%). - Exposure most often involved a combination of **cigarettes and water pipes** (42%, 95% CI 40.5%–43.2%), followed by regular cigarettes alone (27.4%, 95% CI 26.1%–28.6%). - Nearly three quarters (≈74%) of those exposed reported being unhappy with their exposure. - Awareness that SHS poses health risks was reported by 56% (95% CI 55.5%–57.4%) of respondents; 86.5% (95% CI 85.9%–87.2%) supported stronger laws to restrict public smoking. - Main sources of information on SHS risks were social media (75%, 95% CI 74.2%–76.4%) and friends/family (57.9%, 95% CI 56.6%–59.3%). - Factors associated with higher odds of SHS exposure included male sex (OR 1.56; 95% CI 1.16–2.11), current e-cigarette use (OR 1.95; 95% CI 1.33–2.92), unemployment (OR 2.30; 95% CI 1.52–3.48), and lower educational attainment (diploma OR 4.94; 95% CI 3.21–7.59; secondary school OR 2.10; 95% CI 1.52–2.90). - Factors associated with lower awareness of SHS health risks included male sex (OR 0.41; 95% CI 0.31–0.54) and current cigarette smoking (OR 0.55; 95% CI 0.40–0.77); larger households (7+ persons) had higher odds of lacking awareness compared with 1–2 person households (OR 1.70; 95% CI 1.06–2.74). - The study concludes that SHS exposure is common in Saudi Arabia, concentrated in homes and among certain demographic and behavioral groups, and that public knowledge about SHS health risks remains suboptimal. ## Clinical Analysis & Structured Key Points Objective This study aimed to assess the burden of secondhand tobacco smoke (SHS) exposure in the Kingdom of Saudi Arabia by examining its prevalence, awareness levels and associated factors. Design Cross-sectional study. Setting A large population-based survey was conducted across Saudi Arabia from March 2023 to January 2024 using non-probability sampling. Participants Adults (≥18 years of age) with Saudi nationality and presently residing within the borders of Saudi Arabia. Primary and secondary outcome measures Prevalence of SHS and public knowledge and awareness. The factors linked to exposure and lack of awareness of SHS health risks were assessed. Results A total of 10 082 participants were analysed, of whom 53% were female and 62% were aged 18 - 30. The sample included 36% married, 56% living with their children and 49% living with 3 - 4 people in their household. Around 14% of the sample had comorbid conditions, including heart disease, diabetes mellitus and chronic respiratory disease. The prevalence of SHS in our sample was 50% (95% CI 48.9% to 50.9%), with a considerable prevalence at home (57.1% (95% CI 55.8% to 58.5%)) and (16.2% (95% CI 15.2% to 17.2%)) in cafes, coffee stores and tea houses. Most people were exposed to a combination of cigarettes and water pipes (42% (95% CI 40.5% to 43.2%)) and to regular cigarettes (27.4% (95% CI 26.1% to 28.6%)). Nearly 74% of individuals exposed to SHS were unhappy with their exposure. SHS health risks were known by 56% (95% CI 55.5% to 57.4%) of respondents, while 86.5% (95% CI 85.9% to 87.2%) advocated for stronger laws to stop public smoking. Social media (75% (95% CI 74.2% to 76.4%)) and friends and family (57.9% (95% CI 56.6% to 59.3%)) were respondents' top sources of SHS risk information. An increased risk of SHS exposure was associated with males OR (95% CI): 1.56 (1.16 to 2.11), e-cigarette use OR (95% CI): 1.95 (1.33 to 2.92), unemployment OR (95% CI): 2.30 (1.52 to 3.48) and diploma and secondary school education OR (95% CI): 4.94 (3.21 to 7.59); 2.10 (1.52 to 2.90), respectively. Lack of awareness of SHS health risks is linked to males OR (95% CI): 0.41 (0.31 to 0.54), cigarette smokers OR (95% CI): 0.55 (0.40 to 0.77) and big households (7+ persons) compared with 1 - 2 households OR (95% CI): 1.70 (1.06 to 2.74). Conclusion SHS exposure is prevalent among the Saudi public, particularly in households, among males, e-cigarette smokers and the unemployed. 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