Prevalence, perception, and attitude regarding electronic cigarettes usage among young adults in Riyadh, Saudi Arabia. A cross-sectional study

Objectives: To determine the prevalence of electronic cigarette (e-cigarette) usage among young adults in Riyadh, Saudi Arabia; their perceptions of its harm and legal age, and the reasons and factors influencing their use. Methods: This cross-sectional study was carried out within the general community of Riyadh, Saudi Arabia, between December 2023 and April 2024. Participants aged 18-25 years were included. A selfadministered online questionnaire was used to gather demographic data, perceptions, and attitudes toward e-cigarettes and reasons for their use. Results: The majority of the 476 participants were female (n=378, 79.4%) and Saudi nationals (n=451, 94.7%). Current e-cigarette usage was 10.5% (n=50), being more prevalent among males (n=46, 46.9%) and non-Saudis (n=12, 48%). Respondents living alone (n=11, 34.4%) or with friends (n=4, 80%), those who perceived e-cigarettes as safer than cigarettes (n=38, 42.2%), or were unsure of age restrictions demonstrated high usage. Key motivators included flavors available, stress relief, and curiosity. Conclusion: Eelectronic cigarette use among Riyadh's youth was remarkable, especially among males. Reducing the e-cigarette usage prevalence in Saudi Arabia should be prioritized.