Exploring the prevalence, knowledge, attitudes and influencing factors of e-cigarette use among university students in Palestine: a cross-sectional study

Nazzal, Zaher; Maraqa, Beesan; Azizeh, Razan; Darawsha, Bara’; AbuAlrub, Ibraheem; Hmeidat, Mousa; Al-Jabari, Fadel

doi:10.1136/bmjopen-2023-080881

Cited by 6 publications

(2 citation statements)

References 38 publications

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“…This prevalence is higher than what was reported in two prior Palestinian studies which were 13.3% [ 32 ]. On the other hand, our results are similar to what was reported from a recent study conducted on a larger sample of Palestinian students that was conducted on several universities in which the prevalence of e-cigarette use was 19.7% [ 34 ]. These discrepancies in prevalence could be attributed to the sample size, sampling methods, and sociodemographic differences.…”

Section: Discussionsupporting

confidence: 91%

“…Recently, Nazzal et al, reported that the prevalence of e-cigarette use was high (19.7%) among students recruited from six Palestinian universities [ 34 ]. Moreover, Nazzal found that students’ knowledge about e-cigarette use was suboptimal, with misconceptions regarding their safety and health effects, in addition to the presence of negative attitudes towards e-cigarette use.…”

Section: Introductionmentioning

confidence: 99%

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E-cigarette use among university students in Palestine: Prevalence, knowledge, and determinant factors

Ghanim,

Rabayaa,

Abuawad

et al. 2024

PLoS ONE

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Background Recent reports indicated accelerated rates of e-cigarette use, especially among youth in various Middle Eastern countries, including Palestine. Nevertheless, little is known about knowledge, attitudes, and perceptions regarding this topic in Palestine. This study aimed to assess the prevalence of e-cigarette use among Palestinian university students, along with their knowledge, attitudes, and perceptions about e-cigarette use. Methods An observational cross-sectional study, utilizing an online self-administered questionnaire, was conducted on Palestinian students from five universities between 17/04/2023 and 04/11/2023. Results A total of 1002 Palestinian university students completed the questionnaire. The prevalence of e-cigarette use among students was 18.1%. The mean knowledge score about e-cigarettes was significantly lower among the users of e-cigarettes compared to non-users. E-cigarette use was significantly associated with the participants’ smoking status. Among e-cigarette users, 43.6% were also current traditional cigarette users, and 66.9% were current waterpipe users. E-cigarette use was significantly associated with having a friend who is a smoker and/ or a smoking mother. Binary logistic regression revealed a significant positive effect between the participant’s smoking status, the mother’s smoking status, knowledge about e-cigarettes, and the use of e-cigarettes (p-value < 0.05). Among e-cigarette users, 18.8% used them in indoor places at the university, and 25% reported using them daily in the past month. Affordability of e-cigarettes was the most reported reason for their use (47.5%). Conclusion This study concluded that e-cigarette use is prevalent and rapidly rising among university students in Palestine. This is worrisome as it is significantly associated with insufficient knowledge about the adverse health effects of E-cigarette use, and its addictive nature. These findings focus on the importance of improving the students’ knowledge about e-cigarette use by implementing educational campaigns and considering age regulations on e-cigarette availability and use.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

E-cigarette use among university students in Palestine: Prevalence, knowledge, and determinant factors

Ghanim,

Rabayaa,

Abuawad

et al. 2024

PLoS ONE

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Assessment of e-cigarette dependence and influencing factors among Palestinian young adults: a cross-sectional study

Maraqa,

Nazzal,

AbuAlrub

2024

Sci Rep

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E-cigarette use is a growing public health concern, especially because of the potential health risks it poses. This study focuses on assessing e-cigarette dependence and the factors associated with it among Palestinian young adults. A cross-sectional survey was conducted from January to May 2023 among university students in the West Bank. A self-administered questionnaire was used to collect demographic data, knowledge, and attitudes regarding e-cigarettes. E-cigarette dependence was assessed using the Penn State Electronic Cigarette Dependence Index. The study included 386 university students who used e-cigarettes. Many of them started using e-cigarettes at a young age, and 54.7% were dual users of e-cigarettes and traditional tobacco. High levels of dependence were reported in 11.4% of participants, and moderate dependence in 28.8%. Several factors were identified through multivariate linear regression as significantly associated with e-cigarette dependence: a higher monthly allowance (β = 0.116, 95% CI: 0.128- 1.124, p = .014), having a father who uses tobacco (β = 0.095, 95% CI: 0.030- 1.638, p = .042), having a close friend who smokes traditional cigarettes (β = 0.095, 95% CI: 0.019- 1.667, p = .045), using e-cigarettes in areas where traditional smoking is prohibited (β = 0.175, 95% CI: 0.689–2.330, p < .001), using e-cigarettes to quit other forms of tobacco (β = 0.134, 95% CI: 0.434–2.314, p = .004), and a more negative attitude score (β = − 0.210, 95% CI: − 0.285- − 0.112, p < .001). The study revealed high levels of e-cigarettes dependence among the participants among young adults, with associated variables such as monthly allowance, attitudes, and age of e-cigarette initiation. Policymakers, educators, and healthcare professionals should collaborate to address e-cigarette dependence among young adults, taking into consideration social, environmental, and socioeconomic factors.

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Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis

Awad,

Itumalla,

Gaidhane

et al. 2024

BMC Psychiatry

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Background The proliferation of electronic cigarettes (e-cigarettes) has presented new challenges in public health, particularly among adolescents and young adults. While marketed as safer than tobacco and as cessation aids, e-cigarettes have raised concerns about their long-term health and psychosocial impacts, including potential links to increased suicidal behaviors. This study aims to evaluate the relationship between e-cigarette use and suicidal behaviors by conducting a systematic review of the current literature. Methods We searched PubMed, Web of Science, and EMBASE for studies up to March 10, 2024, examining the relationship between e-cigarette use and suicidal behaviors. Eligible studies included cross-sectional, longitudinal, retrospective, prospective, and case–control designs. Meta-analysis was performed to calculate pooled odds ratios (ORs). Newcastle Ottawa scale was used to assess the quality of studies. R software (V 4.3) was used to perform the meta-analysis. Results Our analysis included fourteen studies, predominantly from the US and Korea, with participants ranging from 1,151 to 255,887. The meta-analysis identified a significant association between e-cigarette use and an increased risk of suicidal ideation (OR = 1.489, 95% CI: 1.357 to 1.621), suicide attempts (OR = 2.497, 95% CI: 1.999 to 3.996), and suicidal planning (OR = 2.310, 95% CI: 1.810 to 2.810). Heterogeneity was noted among the studies. Conclusion E-cigarette use is significantly associated with the risk of suicidal behaviors, particularly among adolescents. The findings underscore the necessity for caution in endorsing e-cigarettes as a safer smoking alternative and call for more extensive research to understand the underlying mechanisms. Public health strategies should be developed to address and mitigate the risks of suicidal behaviors among e-cigarette users.

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Exploring the prevalence, knowledge, attitudes and influencing factors of e-cigarette use among university students in Palestine: a cross-sectional study

Cited by 6 publications

References 38 publications

E-cigarette use among university students in Palestine: Prevalence, knowledge, and determinant factors

E-cigarette use among university students in Palestine: Prevalence, knowledge, and determinant factors

Assessment of e-cigarette dependence and influencing factors among Palestinian young adults: a cross-sectional study

Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis

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