Smoking Prevalence, Knowledge, and Attitude among College Students of Riyadh Elm University: A Cross- Sectional Study

Introduction: This quantitative, non-experimental, cross-sectional survey investigated the prevalence of smoking, health risk knowledge, and attitudes towards smoking among 400 undergraduate students at Riyadh Elm University. The study aimed to provide a comprehensive understanding of these factors within this specific student population. Methods: A self-administered structured survey, validated by six experts (Cronbach's alpha = 0.732; test-retest r = 0.778), was used. Ethical approval was obtained from the Institutional Review Board, and written informed consent ensured voluntary, anonymous, and confidential participation. Results: Findings revealed 17.75% of students were current smokers, with 83.10% initiating before age 18 and 55% consuming 6-10 cigarettes daily. Students showed high knowledge of major risks like lung cancer (91.75% correct) and pregnancy harm (94.25% correct). However, significant misconceptions persisted, notably that shisha/waterpipe is less harmful (49.50% incorrect) and secondhand smoke is not harmful (50.75% incorrect). Attitudes were neutral on smoking as a social behavior, yet strongly positive towards complete campus bans (mean=3.578), increased tobacco taxes (mean=3.340), and advertising prohibition (mean=3.570). Students also expressed high demand for university-provided cessation support (mean=3.688). Conversely, a negative attitude was observed towards a complete public smoking ban in Riyadh (mean=2.088). A statistically significant positive correlation existed between knowledge and attitude towards smoking (r = 0.443, P < 0.05), supporting the Knowledge-Attitude-Practice model. Knowledge levels varied significantly by age, gender, and current residence, but not by year level. Conclusion: This study highlights a notable smoking prevalence and critical knowledge gaps among Riyadh Elm University students, despite general awareness of major risks. The findings underscore the urgent need for targeted, comprehensive tobacco control interventions within this population, focusing on correcting specific misconceptions, enhancing self-efficacy for quitting, and expanding accessible cessation support services on campus to foster healthier behavior.