Assessment of withdrawal symptoms among e-cigarette users in Saudi Arabia

E-cigarette use or 'vaping' is increasing globally. Withdrawal symptoms have been extensively researched in tobacco users, but less is known regarding withdrawal among e-cigarette users. We aimed to explore the type, relative frequency, and severity of withdrawal symptoms experienced by e-cigarette users in Saudi Arabia.

A cross-sectional survey was administered to e-cigarette users aged ≥18 years residing in Saudi Arabia in 2023, using a convenience sampling frame. The primary outcome is the withdrawal symptoms. Descriptive statistics and correlations were employed to analyze the data.

Data from 339 participants were analyzed: 87% males, 66% students, 90% used nicotine-containing e-cigarettes, with 55% using higher strength nicotine concentrations (>18 mg/mL). The most frequently reported psychological withdrawal symptoms were intense cravings for nicotine (43%), anger (29%), restlessness (28%), and poor concentration (20%), while 71% of participants reported experiencing at least one withdrawal symptom. The most commonly reported physical withdrawal symptoms were headache (34%), dizziness (17%), heart palpitations (15%), and breathing difficulties (14%). Approximately 42% of participants reported moderate-to-severe withdrawal symptoms. Notably, 36.9% returned to smoking to alleviate withdrawal symptoms.

E-cigarette users in Saudi Arabia experienced a range of psychological and physical withdrawal symptoms. Psychological symptoms were more commonly reported than physical ones. Further studies are warranted to elucidate the factors influencing the occurrence and severity of these symptoms.