Measuring What Matters: Using Participatory Choice Modelling to Understand Preferences for Homelessness Integrated Care.

Tobacco use remains one of the leading preventable causes of morbidity and mortality worldwide. According to the World Health Organization (WHO), tobacco use accounts for over eight million deaths annually. In Saudi Arabia, despite ongoing governmental efforts to curb tobacco consumption through regulatory frameworks and public health campaigns, smoking prevalence continues to represent a major health challenge. Recent estimates suggest that approximately 12–21% of the Saudi adult population engages in some form of tobacco use, with wide variation across regions, age groups, and socioeconomic groups. Nicotine replacement therapies (NRTs) have been recognized globally as first-line pharmacological interventions for smoking cessation. These products, including nicotine patches, gum, nasal sprays, inhalers, and lozenges, deliver controlled doses of nicotine to alleviate withdrawal symptoms and reduce cravings associated with tobacco abstinence. Systematic reviews have reported that NRTs increase the likelihood of successful quit attempts by 50–70% compared to placebo or no pharmacotherapy. More recently, nicotine pouches have entered the Saudi market as consumer products and promoted by manufacturers as a form of harm reduction; however, these are not classified as pharmacological NRT, and their role within formal cessation programs has not yet been established. In the Saudi context, several factors affect NRT adoption and effective use. Cultural norms, gender-specific behaviors, and socioeconomic factors influence smoking patterns and cessation behaviors. Al-Nimr et al. identified that cultural expectations and social environments significantly influence smoking initiation and cessation among Saudi women. Tobaiqy et al. noted gaps in awareness and utilization of evidence-based cessation resources, highlighting the need for culturally sensitive health education strategies.