Knowledge, attitudes, and perception toward new psychoactive substances among Saudi university students: a...

New psychoactive substances (NPS) are defined as chemical compounds that are synthesized or extracted from natural sources with the aim of producing psychoactive effects similar to those produced by controlled substances but not regulated under current legislation. Worldwide, the rise in the use of NPS has been outpacing regulation and education efforts, leading to substantial health risks, especially for the young adults' population. In Saudi Arabia, substance-use prevention is supported through the Saudi 2030 initiative led by the Ministry of Interior and National Committee for Narcotics Control; nonetheless, most studies conducted at the national level have centered on traditional drugs only.

The purpose of this research was to evaluate the knowledge, attitude, and perception related to NPS among King Faisal University students, and to determine the predictors of better knowledge and permissive attitude.

A cross-sectional study was conducted with 300 students via an anonymous web-based survey questionnaire to assess sociodemographic characteristics and knowledge, attitude, and perception measures. Ethical approval was obtained from King Faisal University (reference no. KFU-REC-2026-MAR-ETHICS4051) on the 12^th of March 2025. Chi-squared test/Fisher's exact test were applied to understand the relationship between sociodemographic variables and level of knowledge, and independent samples t-test/ANOVA for comparison of mean attitude scores. Logistic regression analysis was conducted to identify independent predictors of high knowledge and permissive beliefs.

Out of the respondents (74% females, mean age 18-24 years), (58%) had high levels of knowledge regarding NPS. Access to NPS was easy for (57%), mostly through online media (70.8%) and past usage of NPS was admitted by (39.7%). Significantly greater knowledge regarding NPS was shown by females compared to males (64.0% vs 41.0%; P<0.001), while being male predicted poor knowledge (AOR = 0.407, 95% CI:0.229-0.722, P = 0.002). Prior NPS use (AOR = 2.502, 95% CI:1.209-5.176, P = 0.013) and easy access (AOR = 2.298, 95% CI:1.233-4.285, P = 0.009) independently predicted permissive beliefs. Common use motivations included social gatherings (47.9%), weight loss (40.3%), and stress reduction (37.0%).

Students have moderate to high levels of knowledge, their attitudes towards NPS were significantly influenced by ease of access on the Internet and previous usage experience. This indicates the necessity of educational measures to tackle the increasing threat posed by NPS to Saudi universities.