Afnan Mohammad Aseeri

Background: Vaccine hesitancy remains an important global public health concern despite the success of childhood immunization programs. Parental concerns regarding vaccine safety, side effects, and misinformation may negatively influence vaccine uptake and contribute to delayed or refused childhood vaccination. This study aimed to assess vaccine hesitancy among Saudi parents in Abha City and identify factors associated with hesitant attitudes toward compulsory childhood vaccination. Methods: A cross-sectional analytical study was conducted among 382 Saudi parents of children younger than 12 years in Abha City, Saudi Arabia, between 1 January and 30 April 2025. Data were collected using a structured Arabic questionnaire assessing sociodemographic characteristics, vaccine knowledge, attitudes, trust, and vaccination behaviors. A composite vaccine hesitancy score was calculated, and participants with scores ≥11 were classified as having high vaccine hesitancy. Firth penalized logistic regression analysis was performed to identify factors independently associated with high vaccine hesitancy. Data were analyzed using R statistical software version 4.4.3. Results: Most participants demonstrated good awareness regarding compulsory childhood vaccination, with 96.9% reporting familiarity with the national immunization schedule. Although overall vaccine confidence was high, 46.1% of participants reported concerns regarding vaccine side effects, and 35.6% had previously delayed or refused a compulsory vaccine for their child. Overall, 5.2% of participants demonstrated high vaccine hesitancy. Firth penalized logistic regression analysis showed that parents older than 40 years (adjusted OR = 6.62, 95% CI: 1.65–38.89, p = 0.006) and female participants (adjusted OR = 3.41, 95% CI: 1.29–9.98, p = 0.013) were independently associated with high vaccine hesitancy. Conclusion: Although vaccine hesitancy was relatively low among Saudi parents in Abha City, concerns regarding vaccine safety and side effects remain common. Targeted educational interventions, effective healthcare communication, and strategies addressing vaccine misinformation are essential to maintain public confidence in childhood immunization programs.

Background: Tobacco smoking cessation is a complex process influenced by biological, psychological, and social factors. Despite the availability of effective cessation interventions, relapse remains common among smokers attempting to quit. This study aimed to identify factors associated with previous smoking relapse and nicotine dependence among smokers attending anti-smoking clinics in Abha City, Saudi Arabia. Methods: An analytical comparative cross-sectional study was conducted among 330 adult Saudi smokers attending the Abha Anti-smoking Clinic and the Erada Anti-smoking Clinic. Previous smoking relapse was defined as having one or more unsuccessful smoking cessation attempts after a period of abstinence. Data were collected using a structured interviewer-administered questionnaire covering sociodemographic characteristics, smoking history, nicotine dependence, withdrawal symptoms, motives for smoking cessation, and relapse-related factors. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence (FTND). Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed. Results: Most participants were male (84.2%) and aged 20–39 years (59.4%). Smoking initiation most commonly occurred between 15 and 20 years of age (68.8%), while 66.4% reported previous quit attempts. Nervousness (84.2%) and stress or tension (74.2%) were the most frequently reported withdrawal symptoms. High and very high nicotine dependence were reported by 26.1% and 14.2% of participants, respectively. High nicotine dependence (AOR = 1.39, 95% CI: 1.15–1.69, p = 0.001) and very high nicotine dependence (AOR = 1.62, 95% CI: 1.21–2.17, p < 0.001) were independently associated with greater odds of previous smoking relapse. Attendance at the Erada Anti-smoking Clinic was associated with lower odds of relapse (AOR = 0.52, 95% CI: 0.29–0.91, p = 0.021). Conclusions: Higher nicotine dependence was independently associated with previous smoking relapse among smokers attending anti-smoking clinics. Comprehensive cessation programs integrating behavioral counseling, pharmacological treatment, and sustained follow-up may improve long-term abstinence and reduce relapse.