A landmark survey of over 1000 Saudi smokers reveals dangerously low knowledge of stroke risks, symptoms, and consequences, despite smoking’s proven deadly link to brain attacks. Researchers uncover critical gaps: 30% never heard of stroke, 44% unaware quitting slashes risk, and 58% can’t name a single symptom. With stroke ranking as Saudi Arabia’s second-leading killer, these findings demand urgent action to empower smokers with life-saving info.​
Stroke strikes silently but devastates—globally claiming 7.3 million lives in 2021 alone, per recent burden data. In the Kingdom, incidence hits 29 per 100,000 annually, fueling disability and death. Smoking, a top modifiable trigger, amplifies danger, yet awareness lags. This cross-sectional probe, spanning December 2024 to March 2025, targeted smokers via social media, yielding 1029 responses from diverse regions.​
Participant Profile: Young, Educated, Yet Clueless
The sample skewed young—61% aged 18-30—with 88% male, 84% university-educated, and 95% urban dwellers. Current smokers dominated (68%), favoring e-cigarettes (40%), cigarettes (34%), shisha (26%). E-cig users leaned high-nicotine (28% 40-50mg), with 10% showing dependence. Packs-per-year averaged 13 for cigarettes, 25 for shisha. Income split: 68% under 10,238 SAR monthly.​
Familiarity faltered fast. About 70% knew stroke basics, but 30% blanked entirely—cigarette smokers worst (37%). Only 11% reported family history; 37% knew a victim. Shockingly, 44% missed quitting’s preventive power, spiking to 54% among cigarette puffers and 43% e-cig users. Shisha smokers fared best on basic awareness (84%).​
These demographics signal opportunity: Educated youth, reachable digitally, could pivot fast with targeted campaigns. Yet, knowledge voids persist, mirroring global smoker blind spots where perceived invincibility trumps facts.
Risk Factor Recognition: Smoking Tops, But Gaps Loom Large
Smokers pegged smoking itself as prime culprit (55%), followed by heart disease (41%) and hypertension (40.8%). Solid, yet incomplete—high cholesterol (25%), obesity/alcohol (27% each), old age (29%), stress (22%), inactivity (22%), diabetes (16%) trailed. A glaring 26% named zero risks; just 4.5% nailed all 10.​
Current smokers outperformed ex-smokers in spotting at least one risk (OR 1.95, p=0.001). Central region residents doubled odds vs. Westerners (OR 2.42, p=0.001). No ties to gender, education, or smoke type here. This paradox—current smokers more clued-in—hints prior warnings stick, but quitting dilutes urgency.
Table 1: Stroke Risk Factor Awareness Breakdown​
| Risk Factor | % Identified | Rank | Notes |
|---|---|---|---|
| Smoking | 55% | 1 | Top recognition |
| Heart Disease | 41% | 2 | Strong CV awareness |
| Hypertension | 40.8% | 3 | Near-top |
| Obesity/Alcohol | 27% | 4-5 | Lifestyle lags |
| Old Age | 29% | 6 | Moderate |
| High Cholesterol | 25% | 7 | Underrecognized |
| Stress | 22.4% | 8 | Behavioral blind spot |
| Inactivity | 21.6% | 9 | Needs emphasis |
| Diabetes | 16% | 10 | Lowest major risk |
| Zero Risks Named | 26% | – | Critical gap |
| All 10 Risks | 4.5% | – | Elite minority |
This table spotlights strengths (smoking/heart awareness) and hopes: Boosting diabetes/inactivity education could lift 80% preventable strokes.
Symptom Spotting: 58% Draw a Blank
Awareness plummeted here—58% identified zero symptoms. Top mentions: Fainting/loss of consciousness (24.2%), speech issues (24.2%), vision loss/double vision (23.8%), severe headache (23.3%). Weaker: Arm/leg weakness/numbness (18.2%), dizziness (17.8%), memory loss (12.2%). Only 13.7% knew all seven; 20% overall hit ≥50% on risks/symptoms combined.​
Predictors shone: Males 2.88x likelier (p=0.001); university grads 47% better than school-only (OR 0.53, p=0.001); current smokers 2.68x over ex (p=0.001). Regional/employment variances nil. Low symptom savvy delays ER rushes—FAST (Face droop, Arm weakness, Speech issues, Time) campaigns could bridge.
Only 20% grasped half or more risks/symptoms, underscoring mass education needs. Encouragingly, smoker status boosts recall, leveraging existing anti-tobacco exposure.
Consequences: 44% Uninformed on Long-Term Toll
Post-stroke fallout awareness: Movement/function problems (37.9%), cognitive/memory issues (34.5%), visual impairments (26.5%). Lagging: Emotional/personality changes (15.6%). Fully 44% named zero; 8% all four.​
Boosters: Central (OR 3.16, p=0.001), Eastern regions (OR 1.52, p=0.02) vs. West; uni education (OR 0.64 school, p=0.02); employed (OR 1.40, p=0.03); current smokers (OR 2.36, p=0.001). Cigarette users doubled e-cig awareness (OR 2.01, p=0.001); shisha lagged (OR 0.63, p=0.01).
These links flag priorities: Target West/South, unemployed, shisha/e-cig crowds. Higher grasp motivates quitting—knowing paralysis/memory wipe hits harder than abstract risks.
Table 2: Predictors of Awareness (OR >1.5 for Encouragement)​
| Factor | Risks OR (p) | Symptoms OR (p) | Consequences OR (p) |
|---|---|---|---|
| Current Smoker | 1.95 (0.001) | 2.68 (0.001) | 2.36 (0.001) |
| Central Region | 2.42 (0.001) | – | 3.16 (0.001) |
| Male Gender | – | 2.88 (0.001) | – |
| Cigarette vs. E-cig | – | – | 2.01 (0.001) |
| University Education | – | 0.53 school (0.001) | 0.64 school (0.02) |
| Employed | – | – | 1.40 (0.03) |
| Eastern Region | – | – | 1.52 (0.02) |
High ORs inspire: Current smokers, males, educated/employed hold edge—amplify via tailored drives.
Stroke Crisis in Saudi Context: Why Smokers Must Act
Saudi stroke burden soars—second death cause, per local data. Globally third, fourth for disability (93M cases). Smoking doubles ischemic odds; e-cigs/shisha emerge threats, yet underplayed. 80% preventable via lifestyle tweaks, but delays from ignorance kill.
Study beats prior Saudi polls: General pop knew more (90% stroke basics), but smokers lag, per Qassim/Taif/Tabuk probes. Regional parallels (Lebanon/Jordan) show smokers consistently worse. Quitting ignorance persists—54% cig smokers blind to benefits, fueling dissonance: “I know it’s bad, but quitting? Nah.”
Health Belief Model frames it: Smokers downplay susceptibility/severity, barriers trump benefits. Optimism bias (“Won’t hit me”) reigns. Yet, current smokers’ edge suggests campaigns pierce—build on it.
Path Forward: Targeted Wins
Urgent calls: Mass media blasts (FAST ads), smoker-specific cessation tying stroke quits, primary care integration. Digital hits youth/e-cig/shisha users. Central/East models succeed—replicate West/South. Leverage unis (84% sample), employers.
Limitations note: Convenience sampling skews young/educated/online; cross-sectional can’t causal. Still, largest Saudi smoker stroke poll, Arabic-validated tool, multi-region span.
Hope gleams: Awareness predictors prove malleable. 55% already link smoking-stroke; nudge to 80% via education halves burden. Quitting programs, per evidence, slash risk 50% in years. Smokers: Know symptoms, quit now—live stroke-free.
Reference: here
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