Background Tobacco smoke is the second leading risk factor for death worldwide. This report aims to determine the recent prevalence of and factors associated with cigarette smoking in Saudi Arabia. Methods Data were pooled from two nationwide cross-sectional surveys conducted in 2018 across the 13 regions of Saudi Arabia. The study targeted Arabic-speaking Saudi residents aged 18 years or older between March and July 2018. Results A total of 7,317 adults across the 13 regions of Saudi Arabia were included in this study. The prevalence of cigarette smoking was 21.4% of the population. The prevalence of smoking was 32.5% among males and 3.9% among females. There is a disparity in cigarette smoking prevalence from one region to another. The Aljwaf, Northen Borders, Riyadh, and Eastern regions have the highest prevalence, while the fewest cigarette smokers live in Aseer Jizan and Albaha. Conclusion The prevalence of cigarette smoking was relatively high among males, those aged 25–44 year old, and those who live in the northern regions.

Background Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of mortality globally. Patient’s adherence to treatment is a cornerstone factor in controlling hypertension and its complications. This study assesses hypertension patients’ adherence to treatment and its associated factors. Methods This cross-sectional study conducted in Riyadh, Saudi Arabia. The study targeted outpatients aged ≥18 years who were diagnosed with hypertension. Participants were recruited using a systemic sampling technique. The two main measurements were assessing adherence rate of antihypertensive medications using Morisky scale and identifying predictors of poor medication adherence among hypertensive patients including socio-economic and demographic data, health status, clinic visits, medication side effects, medications availability, and knowledge. Descriptive and logistic regression analyses were performed to assess factors associated with poor adherence. Results A total of 306 hypertensive outpatients participated in this study. 42.2% of participants were adherent to antihypertensive medications. Almost half of participants (49%) who reported having no comorbidities were adherent to antihypertensive medications compared to participants with one or more than one comorbidities 41, 39% respectively. The presence of comorbid conditions and being on multiple medications were significantly associated with medication adherence (P-values, respectively, < 0.004, < 0.009). Patients with good knowledge about the disease and its complications were seven times more likely to have good adherence to medication (P <  0.001). Conclusions Non-adherence to medications is prevalent among a proportion of hypertensive patients which urges continuous monitoring to medication adherence with special attention to at risks groups of patients. Patients with comorbidities and on multiple medications were at high risk of medication non-adherence. Patients’ knowledge on the disease was one of the main associated factors with non-adherence.

This study aims to describe the distribution of low health literacy (HL) in the population in the Kingdom of Saudi Arabia (KSA), and to analyze factors associated with low HL in KSA. A cross‐sectional national survey using quota sampling, population‐based of residents of KSA conducted via phone interviews supplemented by in‐person interviews. The survey included an overall evidence‐based measurement of HL. Both descriptive statistics of the sample and a multivariable logistic regression model predicting low HL were developed. A total of 3557 surveys were available for analysis, and 46% of the respondents were classified as having low HL. In regression modelling, low HL was associated with older age groups (age 47‐56 odds ratio [OR] 1.60, 95% confidence interval [CI] 1.30‐1.97; age 57‐66 OR 1.38, 95% CI 0.98‐1.94), the regions of Ha’il (OR 0.65, 95% CI 0.5‐0.85) and Najran (OR 1.27, 95% CI 0.99‐1.64), having been formerly married, lower levels of education (less than elementary OR 3.20, 95% CI 2.10‐4.88; and elementary, OR 1.62, 95% CI 1.14‐2.30), lower levels of income, and having sought healthcare exactly three times in the last year. Approximately half of KSA has low HL, and risk factors for low HL were older ages, lower income and education, having been formerly married, and a moderate pattern of health use. Future studies are needed to better characterize the distribution and determinants of low HL across KSA.

Background Chronic diseases are considered the leading cause of mortality in Saudi Arabia. With a lack of national health surveillance systems, this study examines chronic disease prevalence and multimorbidity and their associated factors in Saudi Arabia. Methods Data was pooled from two cross-sectional national surveys conducted across the 13 regions of Saudi Arabia between March and July 2018. The study targeted Arabic speakers aged 18 years or older. The presence of chronic diseases was assessed according to self-reported medical diagnoses of chronic conditions. Multimorbidity was assessed based on the reported number of diseases (no condition, at least 1, and ≥ 2 conditions). Factors associated with chronic diseases’ presence were examined using regression analysis. Results Out of the total participants (N= 7,317), the most reported chronic conditions were cardiovascular diseases (15.1%) followed by respiratory diseases (14.16%). The multimorbidity prevalence (≥ 2 chronic conditions) was nearly 5.6% (n= 564). Factors found to be significantly associated with the presence of chronic diseases were age, gender, employment status, marital status, and smoking. The findings showed that those who rated their health as fair or poor were almost three times more likely to be diagnosed with at least one chronic condition (95% CI: 2.21 - 3.56, P <0.001). Conclusions The study found a proportion of Saudis living with chronic diseases and multimorbidity with the highest risk among elderly people. The study findings are useful in building a sustainable health surveillance system and designing effective health policies and interventions to tackle the burden of chronic disease in Saudi Arabia.

Background Diet, health, physical activity, tobacco use, and mental health are risk factors that contribute to an increased incidence of NCDs. This report aims to determine overall health status, nutritional perceptions, knowledge, behaviors, and shopping practices among the Saudi population. Methods A nationwide cross-sectional survey was conducted among Saudi residents aged ≥ 18 years. This study used a stratified quota sampling technique to get an equal distribution of participants across the 13 regions of Saudi Arabia. Results A total of 3,699 people across all 13 regions in Saudi Arabia were interviewed. Of those, 15.2% reported that they had at least one chronic disease, 12.5% were at risk of depression, and 16.4% were regular smokers. Overall, 25.9% of participants were obese (29% of men and 26.5% of women). Less than two thirds (60.5%) of participants were physically active, with an average of 53 minutes of physical activity per day. A lack of willpower was the most-reported reason for not being active. A very small portion of participants ate fruit (5.8%) and vegetables (7.3%). During the last seven days, 19.9 % had taken supplements, and 54.65% of those  reported that they used supplements for medical reasons. Conclusion Further research is needed to develop evidence-based nutrition guidelines to address food consumption and Saudi dietary habits.

<b><i>Background:</i></b> Trust in vaccines is a major global health issue. This study aimed to assess vaccine hesitancy among healthcare providers. <b><i>Methods:</i></b> This was a multicenter cross-sectional survey conducted among healthcare providers in Riyadh between October and November of 2020. COVID-19 vaccine hesitancy was assessed using eight structured items adapted from the 5Cs. <b><i>Results:</i></b> About 34.6% (95% CI: 27.6–42.4%) of participants were willing to vaccinate against COVID-19, and 44% (95% CI: 36.5–51.9%) will recommend the vaccine to their patients. About 45% of participants were neutral regarding vaccine safety, and 40% were neutral regarding vaccine effectiveness. Almost 70% believe that the duration of clinical studies of the COVID-19 vaccines affects their confidence in the effectiveness and safety of the vaccine. Those who never hesitated or delayed taking any of the recommended vaccination were more likely to be willing to vaccinate against COVID-19 (OR: 5.46, 95% CI: 2.49–11.98). <b><i>Conclusions:</i></b> With the development of COVID-19 vaccines, hesitancy toward vaccines was observed among healthcare providers due to concerns regarding their safety, effectiveness, and rapid development of vaccines. Improving the level of vaccine confidence among healthcare providers is essential to help implement an effective national vaccine program to enhance vaccination uptake among both HCPs and the public during pandemics.

The spread of tobacco smoking has increased over time at the global and national levels. One of the widely spread tobacco products is waterpipe. Recent studies showed that waterpipe tobacco smoke contains toxic substances, including carbon monoxide and nicotine. Some of them are genotoxic carcinogen, such as formaldehyde. This study aims to provide comprehensive insight into the types and depth of the scientific literature on waterpipe tobacco smoke chemical content, its genotoxic effects, and waterpipe device microbial contamination. We conducted a systematic comprehensive review of articles published between 1986 and December 2018. Primary research articles focusing on the content of waterpipe smoke, including chemical, genotoxic, and microbial contaminants, were eligible for inclusion. Of the 1,286 studies generated, 22 studies were included. Twenty-three chemical families were extracted from waterpipe smoke. Aldehydes were the most identified chemical family in 6 studies, and next is polycyclic hydrocarbons, found in 5 studies. About 206 chemical compounds were identified. Flavobacterium, Pseudomonas, coagulase-negative Staphylococci, and Streptococcus were the most abundant pathogen contaminants. Waterpipe smoke had elevated levels of many DNA damage markers (8-hydroxy-2′-deoxyguanosine and cytochrome P450 1A1) and inhibited levels of many DNA repair genes ( OGG1 and XRCC1) in waterpipe smokers. Waterpipe smoke is associated with the genotoxic effect, which elevates the levels of many DNA damage markers and inhibits the levels of many DNA repair genes. In addition, waterpipe smoking can expose smokers to a range of pathogenic bacteria.

Introduction Tobacco use has been associated with many health risks that can lead to premature death. This study aims to assess the national prevalence of tobacco consumption and the associated determinants in Saudi Arabia.  Methods The study involved a cross-sectional national survey of 5175 individuals conducted across the 13 official regions of Saudi Arabia. The sample included individuals aged 18 years and above from both genders recruited using a quota sampling technique. Data collection was carried out between September 2018 and May 2019 through Web-based computer-assisted telephone interviews (CATIs). Participants were asked to report their current consumption of tobacco products including cigarettes, shisha (waterpipe), smokeless tobacco, cigars, pipes, and electronic cigarettes/vaping. Knowledge of specific health risks associated with smoking and public perceptions of the smoking phenomenon were also assessed among never smokers, smokers, and former smokers. Results The national prevalence of tobacco consumption was 24.02% (1120/5175). Cigarettes were the most prevalent tobacco product consumed (16.18%; 95% CI: 14.5881–17.7663), and daily cigarette smoking prevalence was the highest (14.12%; 95% CI: 12.6433–15.5924). Shisha smoking prevalence was 8.12% (95% CI: 6.8054–9.4352). E-cigarette use prevalence was 2.22% (95% CI: 1.5770–2.8711). The most common tobacco product used among males was cigarettes (15.13%; 95% CI: 13.58–16.67), while shisha was commonly used among females (1.57%; 95% CI: 1.11–2.04). Cigarette smoking prevalence was the highest in the Aljawf region (21.12%; 95% CI: 17.07–25.18), shisha smoking prevalence was the highest in the Makkah region (12.41%; 95% CI: 8.64–16.17), whereas smokeless tobacco use was prevalent in the Najran region (4.75%; 95% CI: 2.81–6.70). Males (AOR: 8.17; 95% CI: 5.98–11.71; P < 0.0001), young adults below 45 years of age (AOR: 2.12; 95% CI: 1.50–2.98; P < 0.0001), and those with below a bachelor’s degree (AOR: 1.34; 95% CI: 1.01–1.77; P = 0.0396) were more likely to consume tobacco compared with others. The population mean knowledge scores of health risks associated with smoking among smokers was 1.91 ± 1.72 (Range: 0–10), with the highest knowledge scores (2.16 ± 1.68) among former smokers. Only 46.53% (95% CI: 44.30–48.75) of the population are bothered “to very large extent” by smoking health consequences. Conclusions Tobacco consumption is prevalent in Saudi Arabia. Different forms of tobacco use were reported, and the most common was cigarettes, followed by shisha and then electronic cigarettes. Tobacco use remains one of the major threats to the health of the population in Saudi Arabia.