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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