Association between knowledge of electronic cigarettes and HTPs and intentions to use among university students: A cross-sectional study

OpenAlex English

INTRODUCTION: Electronic cigarettes and heated tobacco products (HTPs) have become increasingly visible among young adults. This study examines the association between university students' level of knowledge about these products and their intention to use them. METHODS: This cross-sectional study was conducted among 382 university students aged 18-25 years in Türkiye. Participants were recruited using a convenience sampling method. Knowledge of electronic cigarettes and HTPs was assessed using true, false, or 'I don't know' items. Intention to use was measured with Likert-type items. Group differences were analyzed using the Mann-Whitney U test, and associations were examined using Kendall's tau-b correlation coefficient. Multivariable ordinal logistic regression analyses were performed to adjust for potential confounding factors. Statistical significance was set at 0.05. RESULTS: Awareness of electronic cigarettes was high (94.2%), whereas current use was low (0.8%). For HTPs, awareness was 34.8%, and current use was 3.7%. The mean knowledge scores were 3.25 ± 2.22 for electronic cigarettes and 2.22 ± 2.51 for HTPs. Students who indicated that they might consider trying an HTP if offered by a friend had higher knowledge scores (p=0.047). Weak but statistically significant positive correlations were observed between knowledge of electronic cigarettes and intention to use within the next six months (τ-b=0.143; p<0.001), as well as overall propensity to use (τ-b=0.165; p<0.001). However, in multivariable analyses, knowledge was not independently associated with intention to use either electronic cigarettes or HTPs, while conventional cigarette use and peer use were significantly associated with intention outcomes. CONCLUSIONS: Knowledge level was not independently associated with intention to use electronic cigarettes or HTPs. Knowledge alone may not be sufficient to explain differences in intentions among young adults, and behavioral and social factors may play a more prominent role.