Assessing the knowledge, attitude and practice of electronic cigarettes and their associated factors among undergraduate students of Institute of Medicine, Nepal: a cross-sectional study

Abstract

Background: Electronic cigarettes (e-cigarettes) are gaining popularity globally and becoming popular among young people, including in Nepal. Easy accessibility, appealing ads, and the misconception that e-cigarettes are safer than traditional cigarettes have fueled their rising popularity among university students in Nepal. The lack of comprehensive data on the prevalence and determinants of e-cigarette use among university students in Nepal underscores the urgent need for targeted research in this area. This study aimed to examine the knowledge, attitudes, and practices regarding e-cigarettes, as well as their influencing factors, among undergraduate students at the Institute of Medicine in Kathmandu, Nepal. Methods: We conducted a cross-sectional study with 302 undergraduate students. A self-administered questionnaire assessed their knowledge, attitudes, and practices related to e-cigarettes. Descriptive statistics were reported, and chi-square tests and multivariate logistic regression analyses were performed to determine the statistical association among variables using STATA 14. Results: The mean age of participants was 21.4 ± 2.1 years. Of the 302 respondents, 214 (70.9%) had heard of e-cigarettes. Among them, 71.5% had good knowledge, 62.2% held supportive attitudes, and 79.0% had never used e-cigarettes. Males were more likely to smoke e-cigarettes than females (AOR: 2.27; 95% CI: 1.01–5.01; p = 0.046). Students with friends who smoke were nearly three times more likely to use e-cigarettes (AOR: 3.00; 95% CI: 1.12–7.99; p = 0.028). Supportive attitudes towards e-cigarettes also doubled the likelihood of smoking them (AOR: 2.10; 95% CI: 1.02–4.35; p = 0.045). Conclusion: The study highlights important implications for interventions, policy, and education within Nepal’s medical system. With a notable percentage of students holding supportive attitudes toward e-cigarettes, there is a clear need for targeted behavior change campaigns that educate about the health risks associated with e-cigarettes.