Background: Smoking remains a major preventable cause of morbidity and mortality worldwide and continues to pose a significant public health challenge in Saudi Arabia.

Methods: A cross-sectional study was conducted among adults aged 15–65 years in the Eastern Province of Saudi Arabia between December 2024 and February 2025. Data were collected from 551 participants using a validated self-administered questionnaire distributed online. Sociodemographic characteristics, lifestyle factors, and smoking status were assessed. Associations between smoking behaviour and selected variables were analysed using chi-square tests, with statistical significance set at p < 0.05.

Results: Overall, 29.9% of participants were current smokers, 59.5% were non-smokers, and 10.5% were passive smokers. Smoking prevalence was significantly higher among males compared to females (37.8% vs. 7.6%, p = 0.001). Higher smoking prevalence was observed among participants with diploma-level education, overweight individuals, private-sector employees, and those working in non-healthcare fields (p < 0.05). No significant associations were found with age, marital status, income, chronic diseases, or physical activity.

Conclusion: Smoking prevalence remains high among adults in the Eastern Province of Saudi Arabia and is strongly associated with specific sociodemographic characteristics. These findings emphasize the need for targeted public health interventions, including workplace-based smoking cessation programs and educational campaigns tailored to high-risk and lower-education groups.

Haidar Alabdrabulridha is on has his PhD at the age of 30 years from Lincoln University College, Malysia. He is the deputy head of public health department, medical waste program & training coordinator, of King Fasial General Hospital, KSA. He has been serving as a TOT in Saudi Commission for Health Specialty (SCFHS) & lecturer in the Saudi Soard of Preventive Medicine.