Vaping leads tobacco consumption among university students in Arab countries: a study of behavioral and psychosocial factors associated with smoking
Abstract
Background: E-cigarettes use "vaping" is a growing public health concern. The Arabic-validated Vaping Attitude and Perceptions Scale (VAPeS) instrument assesses vaping determinants across five constructs: Social Influence, Perceived Harms, Vaping Pleasure, Behavioral Influences, and Economic and Self-Efficacy. We aimed to examine the prevalence of cigarette, e-cigarette, and narghile use among Arab university students and to identify the associations between demographic/VAPeS-related variables and the smoking attitudes among vapers.
Methods: A cross-sectional survey was distributed online among university students across Arab countries during January-April 2025. Prevalence estimates were calculated using one-sample proportions with Wilson Score confidence intervals. The modified VAPeS scale comprising four constructs after confirmatory factor analysis (Social Influence, Perceived Benefits, Behavioral Influence - Risk, and Behavioral Influence - Situational Triggers) was used to assess tobacco use attitudes. The primary outcome was the Endorsement of Tobacco Use Attitude Score (ETUAS). Multivariate analyses using multinomial logistic and linear regressions were conducted to examine factors associated with tobacco use attitudes.
Results: Among 1,338 university students surveyed, the majority were from Kuwait (21.0%), Egypt (18.5%), Kingdom of Saudi Arabia (KSA, 17.8%), Jordan (16.7%), and the United Arab Emirates (UAE, 10.0%). Vaping was the most prevalent form of tobacco use…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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