Knowledge, Attitude, and Practice of Dental Students Regarding Electronic Cigarettes and Associated Factors

Abstract

The use of electronic cigarettes (e-cigarettes) has surged globally and is frequently marketed as a safer alternative to traditional tobacco smoking. Nonetheless, the health implications of e-cigarettes remain debated, and their increasing popularity among youth and medical students raises concerns, particularly in countries with limited local research. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding e-cigarettes among dental students at Ashur University in Iraq, while also examining correlations with demographic factors and smoking behavior. A cross-sectional study was conducted from January to March 2025 involving 104 dental students in their fourth and fifth years. The research team developed a structured, self-administered questionnaire based on previous studies to assess demographic data, smoking status, and knowledge (17 items), attitudes (13 items), and practices related to e-cigarettes. Data analysis utilized descriptive statistics and chi-square tests, with a P of ≤0.05 considered statistically significant. Of the 100 valid responses, 50% of participants were male, 69% were aged 20 years or younger, and 91% were unmarried. Nearly half (47%) reported being current smokers, with dual use being the most common pattern at 20%. Knowledge levels regarding e-cigarettes were generally high: 88% acknowledged their harmfulness, 69% recognized their addictive potential, and 50% associated them with cancer risk. In contrast, attitudes were more permissive, with 49% believing that e-cigarettes are less harmful than traditional tobacco, 65% considering them a better option for patients, and 61% supporting a ban on their use. Initiation of e-cigarette use was significantly linked to the smoking habits of peers and family (P<0.001). Social media was identified as the primary source of information, cited by 51% of respondents. No significant associations were found between knowledge or attitudes and demographic factors such as age, gender, or income. Dental students at Ashur University demonstrated a solid understanding of e-cigarettes but held permissive attitudes toward their use, indicating misconceptions about their safety. To address these gaps and enhance preventive measures, awareness programs and integration of this topic into the curriculum are essential.