Understanding of Stroke Risk Among Smokers in Saudi Arabia

<i>Background and Objectives</i>: Stroke is a common and fatal condition impacting millions worldwide. Understanding the risk factors, symptoms, and consequences at an earlier stage, specifically in highly at-risk populations such as smokers, is crucial for mitigating the stroke burden. <i>Materials and Methods</i>: A cross-sectional study was conducted in Saudi Arabia on more than 1000 smokers. The survey was randomly shared across the kingdom. Multiple logistic regression models were applied to assess the association and find the variables associated with poor stroke awareness. <i>Results</i>: The study included 1029 smokers, with 88% (904) being male. The majority (61%; 630) are between the ages of 18 and 30 years, with a university degree (84%, 862). Cigarettes (33.9%; 349), shisha (25.9%; 267), and e-cigarettes (40.1%; 413) were the most common smoking types. About 30% of smokers have never heard of stroke, and 44% were unaware that stopping smoking can prevent stroke. Smokers (55%) perceive smoking as the top risk factor, followed by heart disease (41%), and high blood pressure (40.8%), while 26% of the smokers did not identify any risk factors. Around 58% of the smokers did not identify any stroke symptoms. Only 20% of smokers were capable of identifying 50% of both stroke risk factors and symptoms. Around 8% reported all stroke-related consequences, whereas 44% were unable to identify any. Current smokers were more likely than ex-smokers to identify ≥1 stroke risk factor (OR = 1.95, <i>p</i> = 0.001), with no significant associations found for other variables. Males, university degrees, and current smokers were the only significant predictors for the identification of ≥1 stroke symptom. University education, current smokers, employment, and smoking types were significant predictors in identifying ≥1 stroke consequence. Compared to E-cigarette users, cigarette smokers exhibited twice the awareness of stroke consequences (OR = 2.01, <i>p</i> = 0.001), whereas shisha smokers demonstrated lower awareness (OR = 0.63, <i>p</i> = 0.01). <i>Conclusions</i>: Smokers' awareness of stroke in Saudi Arabia is suboptimal. Targeted educational and smoking cessation initiatives are essential to address this gap and mitigate the impact of smoking-related strokes in Saudi Arabia.