School-based drug prevention in Saudi Arabia: are physical education teachers prepared to act?

Background: Around 70% of Saudi Arabia's drug addicts are under 20, yet drug prevention education (DPE) in Saudi schools remains limited. To address this public health crisis, this study explored whether physical education (PE) teachers can help through school-based prevention initiatives. Data were collected in 2018, providing a baseline assessment at a time when the Saudi school PE workforce was exclusively male. Methods: A cross-sectional survey was conducted among male PE teachers in Riyadh ( Results: Saudi male PE teachers demonstrated generally adequate knowledge about drug abuse prevention (mean = 5.47/7), though misconceptions persist regarding "gateway" substances such as e-cigarettes and amphetamines. PE teachers expressed strong support for integrating drug prevention into the PE curriculum and believed they could positively influence students' behavior. Knowledge scores significantly predicted preventive practices, while attitudes and beliefs showed moderate associations with implementation. Despite positive perceptions, most teachers reported limited formal training in DPE and poor awareness of national prevention standards. Many relied on personal judgment rather than evidence-based approaches when discussing substance misuse with students. Conclusion: Saudi male PE teachers represent a potentially valuable but underutilized resource in DPE. Their close and consistent interaction with students means PE teachers are ideally positioned to promote healthy behaviors, reinforce resilience, and identify early warning signs of substance misuse. However, gaps in DPE training, policy awareness, and evidence-based practice limit their effectiveness. Expanding professional development and incorporating structured prevention education into PE curricula could strengthen school-based public health interventions and contribute to reducing adolescent substance abuse.