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Prevalence of E-Cigarettes and Its Role in Shaping Physical Activity and Mental Health in Saudi Arabia

A Cross-Sectional Survey

Bibliographic Data

ID21645231
AuthorsShehata Farag Shehata (King Khalid University), Ali S Al-Qahtani (0009-0004-5699-3598, King Khalid University), Mai El-Shishtawy (Alexandria University), Huda Turki Alshahrani (King Khalid University), Layan Saeed Alshmrani (King Khalid University), Shaden Essa Y Hammati (King Khalid University), Fahad Abdullah S Alshahrani (0009-0007-5753-1688, King Khalid University), Saud Turki M Alqahtani (King Khalid University), Asma Abdulrahman Nasser (King Khalid University), Rima Ahmed Asiri (King Khalid University), Aliaa Yasser Mohamed (Alexandria University), Sarah Hamed N Taha (0000-0002-0777-7678, Cairo University), Sherif Nasser Taha (Cairo University, corresponding author), Ramy Mohamed Ghazy (0000-0001-7611-706X, King Khalid University)
Year2026
Volume61
Issue10
Pages1645-1657
Publication date2026-08-24
Open AccessYes
TypeARTICLE
VenueSubstance Use & Misuse (JOURNAL)
Journal identifiersISSN: 1082-6084 • E-ISSN: 1532-2491
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/10826084.2026.2617442
PMID41619783
OpenAlexW7126382408
LanguageEN
References cited43

Background The rise of electronic cigarettes (e-cigarettes) has attracted both former smokers and teenagers looking for an alternative nicotine source. This study aimed to assess the prevalence of e-cigarette use, the determinants associated with its use, dependence, and the impact of e-cigarette use on physical activity and mental health among the Saudi population.Methods A cross-sectional study was conducted from September 27, 2024, to October 21, 2024. We used Penn State Nicotine Dependence Index, the Kessler Psychological Distress Scale, and the Global Physical Activity Questionnaire. Convenience and snowball sampling methods were used to recruit participants using an electronic survey questionnaire and face-to-face interviews.Results Among 3092 participants, the prevalence of e-cigarette use was 9.8%.Nicotine dependence was notable among users, with 41.7% exhibiting medium dependence and 22.2% reporting high dependence. Physical activity levels varied: 22.3% engaged in high activity, 34.1% in moderate, and 24.3% in low activity. Regarding mental health, 42.2% experienced high psychological distress. Participants with high physical activity had significantly higher odds of e-cigarette use [crude odds ratio (cOR) = 1.79, 95% confidence interval (CI): 1.29–2.49], while those with high distress had lower odds [cOR = 0.27, 95% CI: 0.19–0.39]. Path analysis revealed that mental distress positively predicted e-cigarette dependence (β=0.118), whereas physical activity showed a small positive association with dependence (β=0.209).Conclusions E-cigarette use in this population is significantly influenced by socio-demographic factors, physical activity levels, and mental health status. The complex relationship observed, where high physical activity is associated with use and mental distress is protective against initiation but predictive of dependence, highlights the need for integrated public health strategies. Interventions should focus on high-risk groups and address the dual role of lifestyle and psychological factors in both prevention and dependence management

Distress · Mental distress · Mental health · Physical activity · Population · Psychological distress · Psychological intervention · Public health · Physical Activity and Health · Smoking Behavior and Cessation · Substance Abuse Treatment and Outcomes

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