The Association Between E-cigarettes and Smoking Initiation Among Students at the Hashemite University in Jordan.

Abstract

Background : Despite the explosive rise of electronic cigarettes being marketed as a healthier, more suitable alternative to traditional tobacco cigarettes, they still pose significant risks. Not only are they proven to contain carcinogenic inhalation byproducts, but they also play a crucial role in initiating tobacco use, even among those who were not smokers at baseline.
Methods. A cross-sectional study was conducted to examine the association between e-cigarette use and the initiation of traditional tobacco smoking among students at The Hashemite University in Jordan, with a sample of 245 participants.
Results : A chi-square test was used to assess associations between categorical variables, including the relationship between e-cigarette use frequency and (a) having friends who smoke traditional tobacco and (b) difficulty quitting e-cigarettes. 70.0% of participants reported starting to use tobacco products after trying e-cigarettes, indicating that most transitioned to traditional cigarettes. Regarding smoking other tobacco products alongside e-cigarettes, 41.3% of participants use traditional cigarettes, while 40.7% smoke hookah. Regarding the frequency of smoking other tobacco products alongside e-cigarettes, 42.3% of respondents report almost daily use, and 24.5% smoke 1611-1622 days per week. E-cigarette use frequency was a significant predictor (p=0.013), with higher frequency increasing the odds of initiating traditional smoking by about 1.6 times (OR=1.618, 95% CI=1.1611-1622.365). There is also a statistically significant association (p-value < 0.05) between e-cigarette use frequency and having friends who smoke traditional tobacco. Smoking frequency was also tied to difficulty quitting, with a highly significant association (p-value < 0.05) between cigarette use frequency and difficulty quitting, and quitting difficulty was reported by 48.2% of participants.
Conclusion. There is a significant association between initiating e-cigarette use without a prior history of tobacco smoking and transitioning to tobacco smoking. Frequency of e-cigarette use is a significant predictor of whether a person will transition to tobacco smoking, with higher frequencies linked to a greater likelihood of initiation.