Abstract

Objective: This study aimed to assess awareness regarding the association between smokeless tobacco (SLT) use and oral cancer among adult residents of Makkah, Saudi Arabia.
Methods: A community-based cross-sectional study was conducted among 438 adults living in Makkah using a validated self-administered questionnaire. Data on sociodemographic characteristics, awareness of oral cancer, knowledge of risk factors, SLT use, attitude, and healthcare exposure were collected.
Results: Overall, 62.8% of participants had heard of oral cancer. Smoking (83.8%), SLT (62.1%), and khat use (66.9%) were the most commonly recognized risk factors. High knowledge levels were observed in 34.0% of participants, whereas 28.1% demonstrated poor knowledge. Most participants had never smoked (79.0%) or used Shamma (95.2%). Healthcare exposure was limited, with only 5.6% reporting that healthcare providers had asked about Shamma use. Higher awareness was significantly associated with job status, family income, healthcare visits, exposure to health warnings about Shamma, and recognition of chewing tobacco as a risk factor for oral cancer (p-value < 0.05).
Conclusion: Awareness of the association between Shamma and oral cancer was moderate among adults in Makkah, with important gaps in knowledge. Strengthening public education, tobacco cessation programs, and healthcare provider involvement may improve awareness and support oral cancer prevention.

Key words: Oral cancer, smokeless tobacco, Shamma, awareness, Saudi Arabia, Makkah