Prevalence, awareness and self-reported health effects of oral nicotine pouch use among university students in Saudi Arabia: a cross-sectional study
Abstract
Background and aimOral nicotine pouches (ONP) are marketed as tobacco-free alternatives, perceived as safer than traditional tobacco; however, they carry significant health risks. This study aims to assess the prevalence of ONP use among students at King Saud University, awareness of ONP, and explore perceived health impacts.MethodsA cross-sectional study was conducted by distributing a structured, self-administered and pilot-tested online questionnaire among the students of King Saud University. Data were collected on demographics, ONP use, awareness and perceived health risks. Chi-square tests, one-way ANOVA, Kruskal–Wallis tests and binary logistic regression were used for analysis.ResultsThe respondents were 1,028 students. The prevalence of ONP use was 36.0%, and use was significantly more prevalent among males (47.1%) than females (6.7%); males constituted 94.9% of all users. Among users, the most frequently reported adverse effects were increased salivation (43.0%), nausea (40.3%) and upset stomach (31.4%). Awareness of ONP was high (86.8%); however, knowledge of specific health risks, such as cardiovascular effects (49.8%), was considerably lower.ConclusionONP use is notably high among students at King Saud University, particularly males, compared to other countries. Although general awareness was high, a critical deficit exists in knowledge of specific health risks, especially cardiovascular effects. Increased salivation (43.0%) and nausea (40.3%) were the most frequently reported adverse effects. These findings underscore the urgent need for targeted public health campaigns to educate young adults about the potential harms of ONP use. Future research should explore longitudinal designs to explore long-term health effects, assess the impact of awareness initiatives, and examine psychosocial and cultural influences on ONP use across diverse populations.
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BibTeX
@article{alsahly2026prevalence,
title = {{Prevalence, awareness and self-reported health effects of oral nicotine pouch use among university students in Saudi Arabia: a cross-sectional study}},
author = {Musaad Bedah Alsahly and Mohammed Fahad Alkodhari and Ayidh Hussain Alqantash and Khalid Foheid Alsobei and Abdulaziz Ali Alamri and Waleed Abdulrahman Alrasheed and Hamad Fahad Alzomaia and Thamer Abdullah Alsufayan and Ali Mohammed Alsaud and Thamir Al-Khlaiwi},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1959541},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1959541},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prevalence, awareness and self-reported health effects of oral nicotine pouch use among university students in Saudi Arabia: a cross-sectional study
AU - Musaad Bedah Alsahly
AU - Mohammed Fahad Alkodhari
AU - Ayidh Hussain Alqantash
AU - Khalid Foheid Alsobei
AU - Abdulaziz Ali Alamri
AU - Waleed Abdulrahman Alrasheed
AU - Hamad Fahad Alzomaia
AU - Thamer Abdullah Alsufayan
AU - Ali Mohammed Alsaud
AU - Thamir Al-Khlaiwi
PY - 2026
DA - 2026/11/06
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1959541
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1959541
AB - Background and aimOral nicotine pouches (ONP) are marketed as tobacco-free alternatives, perceived as safer than traditional tobacco; however, they carry significant health risks. This study aims to assess the prevalence of ONP use among students at King Saud University, awareness of ONP, and explore perceived health impacts.MethodsA cross-sectional study was conducted by distributing a structured, self-administered and pilot-tested online questionnaire among the students of King Saud University. Data were collected on demographics, ONP use, awareness and perceived health risks. Chi-square tests, one-way ANOVA, Kruskal–Wallis tests and binary logistic regression were used for analysis.ResultsThe respondents were 1,028 students. The prevalence of ONP use was 36.0%, and use was significantly more prevalent among males (47.1%) than females (6.7%); males constituted 94.9% of all users. Among users, the most frequently reported adverse effects were increased salivation (43.0%), nausea (40.3%) and upset stomach (31.4%). Awareness of ONP was high (86.8%); however, knowledge of specific health risks, such as cardiovascular effects (49.8%), was considerably lower.ConclusionONP use is notably high among students at King Saud University, particularly males, compared to other countries. Although general awareness was high, a critical deficit exists in knowledge of specific health risks, especially cardiovascular effects. Increased salivation (43.0%) and nausea (40.3%) were the most frequently reported adverse effects. These findings underscore the urgent need for targeted public health campaigns to educate young adults about the potential harms of ONP use. Future research should explore longitudinal designs to explore long-term health effects, assess the impact of awareness initiatives, and examine psychosocial and cultural influences on ONP use across diverse populations.
SN - 2296-2565
ER -