Knowledge, Attitude, and Use of E-Cigarettes Among Syrian University Students: A Cross-Sectional Study.

Background and Aims: Studies have shown that electronic cigarettes have gained immense popularity, particularly among university students, as they've been marketed as a safer, cleaner, and more acceptable alternative to traditional tobacco. However, little is known about the knowledge, attitude, and use of e-cigarettes in a developing country such as Syria. This study aimed to investigate the knowledge, practices, and attitudes of Syrian university students regarding e-cigarettes and the demographic factors related to these aspects. Methods: A web-based survey was distributed to university students on social media. A total of 26 questions were used to collect demographic data and evaluate the knowledge, attitude, and use of e-cigarettes. Results: The total number of participants was 1572. The prevalence of e-smoking alone was 24%, while 9.5% smoked e-cigarettes and traditional tobacco together. The most prevalent source of information about e-cigarettes was friends, followed by media, while desirable taste, followed by fun, was the most prevalent reason for using e-cigarettes. The average knowledge score was 5.20 ± 3.01, while the average attitude score was 21.04 ± 4.56. Male gender, parental smoking, and decreased attitude score were independently associated with e-smoking, while studying a medical specialty and decreased knowledge score were associated with e-smoking but not independently. Conclusions: Syrian university students' knowledge about e-smoking is limited. Male gender, parental smoking, and lower attitude scores were independent predictors of e-cigarette use. Academic specialty and knowledge were associated in univariate analysis but were not independent predictors. Awareness campaigns are imperative to counter the increased popularity of e-smoking among the Syrian youth.