Socioeconomic Determinants of Smoking in the Kingdom of Saudi Arabia

Abstract

Tobacco consumption, or smoking, is a major cause of preventable morbidity and mortality worldwide, including in the Kingdom of Saudi Arabia (KSA). In order to reduce the consumption of tobacco products, it is necessary to understand the factors that drive it. However, little is known about the socioeconomic determinants of tobacco smoking in the KSA. This study, therefore, investigates the socioeconomic factors that influence tobacco smoking in the KSA. Using a national health survey, the study employs logistic and negative binomial regressions to examine the socioeconomic factors associated with smoking. Moreover, the inequality concentration indices (CIs) are used to assess inequalities in smoking. The results reveal that the smoking prevalence is 14.09% of the 8813 respondents considered in this study. The prevalence of smoking is higher among men (25.34%) than among women (1.91%). On the determinants of smoking, the logistic regression results show that higher income is associated with lower likelihood of smoking. Other factors significantly associated with current smoking status are marital status, gender, age, and region of residence. Similarly, gender, age and region of residence are significantly associated with smoking intensity. As regards the inequality analysis, at the national level, the results show that smoking is concentrated among those with higher socioeconomic status (income: CI = 0.071, p < 0.01; education: CI = 0.095, p < 0.01), but with significant regional variations. By gender disaggregation, the results also show that the income-based CIs are positive for both males and females, but statistically insignificant. Education-based CI is positive for males and significant (CI = 0.057, p < 0.05), while it is negative and insignificant for females during the study period. The findings call for targeted tobacco control measures focusing on those with higher socioeconomic status, as well as factors such as age, gender, marital status and region of residence.

Impact of taxation policy on tobacco consumption in Saudi Arabia

“…29 Our result is consistent with studies published in 2020 and 2021 indicating that no association was observed between education and intention to quit smoking. 7,29,34 Our estimates of price elasticity of demand corresponded with the changes in taxation policy that increased prices. The positive elasticity figures for the years from 2013 to 2015 were not in alignment with the goals of WHO and the World Bank to reduce consumption by increasing prices.…”

“…8 Gross domestic product lost due to smoking increased from 0.2% in 2012 to 0.98% in 2016. 7 From 2010 to 2014, the cost of import of cigarettes and other tobacco products to Saudi Arabia was worth $3.4 billion. 9 Saudi ranks in the fourth position in tobacco sales and imports across the world.…”

“… 15 In a study published in 2021, 14.1% of the respondents aged 15 years or older smoked cigarettes. 7 The latest survey, conducted by the Saudi Food and Drug Authority in 2018, estimated the adult smoking prevalence at 21.4%. 7 The WHO projects that the male smoking prevalence will reach about 24% by 2025.…”

“… 7 The latest survey, conducted by the Saudi Food and Drug Authority in 2018, estimated the adult smoking prevalence at 21.4%. 7 The WHO projects that the male smoking prevalence will reach about 24% by 2025. 12 There is a growing evidence that raising and enforcement of taxes on tobacco products that target demand-reduction has emerged as the most efficient of the WHO Framework Convention on Tobacco Control (FCTC) MPOWER measures.…”

“…6 In Saudi Arabia, about 70 000 people die annually as a result of cigarette smoking. 7 Smoking was responsible for 280 000 premature deaths between 1996 and 2012. 8 This is the economic burden of tobacco consumption over the last 10 years (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) in Saudi Arabia was nearly $20.5 billion (USD).…”