Smoking Abstinence Self-Efficacy, Decisional Balance, and Quitting Desire Among Adult Smokers in Saudi Arabia: Gender-Based Cross-Sectional Study

Background: Smoking is a major public health concern in Saudi Arabia, with significant gender differences influencing smoking behavior and cessation. Aim: This study aimed to investigate smoking abstinence self-efficacy (ASE), decisional balance (DB), quitting desire, and their predictors among adult male and female smokers in Saudi Arabia. Methods: A cross-sectional study was conducted using a convenience sample of 375 male and 220 female adult smokers recruited via social media. Data were collected through an online survey assessing personal health, smoking behavior, desire to quit, ASE, and DB. Logistic regression was used to identify predictors of earnest quitting desire, high ASE, and negative DB. Results: Males were more likely to smoke for 10 or more years (70.7% vs. 29.1%), maintain regular smoking patterns (86.9% vs. 54.1%), and exhibit high nicotine dependence (29.3% vs. 6.4%) compared to females. A higher proportion of females (76.8%) than males (66.9%) expressed a strong desire to quit. ASE was generally higher in males, with 49.6% showing average levels, while 46.4% of females had low ASE, particularly in social and positive mood contexts. Females displayed a higher prevalence of negative DB (73.6% vs. 58.1%), indicating greater awareness of smoking’s drawbacks. Both genders acknowledged the cons of smoking, though males perceived fewer pros. Conclusions: A complex interplay of factors influences smoking behavior and cessation among adult smokers. Gender differences also play a crucial role in smoking cessation factors among Saudi adults. Tailored cessation strategies addressing self-efficacy and motivation are recommended to enhance quitting success.