Secondhand smoke exposure among Saudi adolescents and its sociodemographic, attitudinal, and behavioral correlates

Abstract Secondhand smoke (SHS) exposure remains common among Saudi adolescents. This study explored its prevalence, correlates, and behavioral consequences. Data were drawn from the 2022 Global Youth Tobacco Survey (GYTS) a school-based cross-sectional survey of 5610 students aged 13–15 years in Saudi Arabia. SHS exposure, tobacco-use behaviors, susceptibility to future use, and tobacco-related attitudes were assessed using standardized GYTS items. Logistic regression analyses were performed to evaluate associations between SHS exposure and smoking-related outcomes. 40.1% of adolescents reported exposure to SHS, most commonly in outdoor public places, enclosed public areas, and schools. Females, students in higher grades, and those with greater spending money had higher odds of exposure. SHS exposure was associated with current and ever use of cigarettes, shisha, e-cigarettes, smokeless tobacco, and heated tobacco products. Exposed adolescents were nearly three times more likely to be susceptible to future tobacco use, particularly shisha and e-cigarettes. SHS exposure was linked to ambivalent attitudes—greater awareness of harms and support for indoor bans, but increased perceptions of smoking as socially enhancing. SHS exposure remains widespread among Saudi adolescents. Stronger enforcement of smoke-free policies in schools and public areas is essential to curb exposure and misconceptions