Knowledge and Attitude toward E-Cigarettes among First Year University Students in Riyadh, Saudi Arabia

Background: Electronic cigarettes are immensely popular among youths across the globe. However, knowledge, attitudes, and perceptions regarding their use vary by country. The present study investigated the knowledge and attitudes toward e-cigarette use among first-year university students in Saudi Arabia. Methods: A cross-sectional design was adopted, and an online, self-administered questionnaire assessing the knowledge of and attitudes toward e-cigarette use was utilized to conduct this study. The study population included students from all streams enrolled in their first year of university. Descriptive statistics were used to report percentages and frequencies, while advanced statistics, such as multiple logistic regression analyses, were used to determine associations. Results: The lifetime and current prevalence of e-cigarette use was 27.4% and 13.5%, respectively, among first-year university students. The mean age of smoking initiation was 16.4 ± 1.2 years. Of e-cigarette users, 31.3% smoked every day and 86.7% used flavored e-cigarettes. Knowledge of the harmful effects of e-cigarettes was high (addiction, 61.2%; asthma, 61%; nicotine content, 75.2%). However, when comparing e-cigarettes to regular cigarettes, only 22.5% and 48.4% of the students reported that they carry the same risk and contain the same chemicals as regular cigarettes do. There was a lack of knowledge (17.1%) regarding government regulations related to e-cigarettes. An attitude of support was observed regarding banning e-cigarettes (2.6 ± 1.5 on a scale of 0 to 4), while at the same time, some associated e-cigarette use with helping to reduce tobacco dependency (2.1 ± 1.2). Marketing adverts were agreed upon to positively influence youth (1.9 ± 1.4). However, the participants’ perceptions relating e-cigarette use to style were not well articulated. Significant gender differences were found: most of the women who participated in the study had better knowledge of e-cigarettes (p < 0.001). Being male, having higher income status (OR = 1.67; p = 0.013), being a current smoker (OR = 11.6; p < 0.001), and having intention for future use (OR = 3.45; p < 0.001) were strong predictors of e-cigarette use. Conclusions: These findings suggested the increasing popularity of e-cigarette use among male first-year university students. More educational campaigns and stricter regulations are needed to curb this trend.