KNOWLEDGE, ATTITUDE, AND PRACTICE OF ELECTRONIC CIGARETTE USE AMONG MEDICAL STUDENTS IN MALAYSIA
Nurul Fathen Nadia A.H., Fatin Anisya Izazi R., Nur Assyaqirin M.A., Alya Khairina R., Atiah Naufal A., Muhammad Faiz M.Z., Muhammad Zulqarnain M.Z., Nur Qistina Batrisyia R. & Harif Fadzilah C.H.
abstract
Electronic cigarettes (e-cigarettes) have become a significant global public health concern, especially among youth. In Malaysia, a country with high tobacco use rates, the popularity of e-cigarette has surged. As future healthcare providers, medical students play a vital role in tobacco control and public health education. This study aims to assess the knowledge, attitudes, and practices (KAP) regarding e-cigarette use among medical students in Malaysia, identifying gaps and trends to inform targeted interventions. This cross-sectional study was conducted among medical students at various universities in Malaysia from June to August 2024. A total of 377 participants were recruited using stratified sampling to ensure representation across pre-clinical and clinical years. Data were collected through an online questionnaire covering demographics, knowledge, attitudes, and practices related to e-cigarette use. Statistical analysis was performed using SPSS version 26. Among the 377 participants, 94.4% demonstrated adequate knowledge about e-cigarettes. Attitudes toward e-cigarettes were balanced, with 157 students holding favourable views and 220 holding unfavourable ones. A small percentage (6.9%) reported current e-cigarette use, with male students more likely to use e-cigarettes than female students. The main reasons for usage were stress relief and peer pressure. In conclusion, this study underscores the importance of enhancing education on the health risks of e-cigarettes among medical students in Malaysia. The results highlight the need for targeted interventions focusing on stress management and public health advocacy to reduce e-cigarette use. Medical students, as future healthcare providers, must be equipped with accurate knowledge and strategies to combat the rising trend of e-cigarette use.
references
1. Pénzes M, Foley KL, Balázs P, Urbán R. Intention to Experiment With E-Cigarettes in a Cross-Sectional Survey of Undergraduate University Students in Hungary. Subst Use Misuse. 2016 Jul 28;51(9):1083–92.
2. Keenan M, Keenan K, Wrotniak B, Qiao H, Emborsky M. Do Your Kids Vape? Pediatr Emerg Care. 2022 Jun;38(6):e1309–13.
3. Goh YH, Dujaili JA, Blebil AQ, Ahmed SI. Awareness and use of electronic cigarettes: Perceptions of health science programme students in Malaysia. Health Educ J. 2017 Dec 28;76(8):1000–8.
4. Sutfin EL, McCoy TP, Morrell HER, Hoeppner BB, Wolfson M. Electronic cigarette use by college students. Drug Alcohol Depend. 2013 Aug;131(3):214–21.
5. Hadland SE, Chadi N. Through the Haze: What Clinicians Can Do to Address Youth Vaping. Journal of Adolescent Health. 2020 Jan;66(1):10–4.
6. Brożek G, Jankowski M, Zejda J, Jarosińska A, Idzik A, Bańka P. E-Smoking Among Students of Medicine—Frequency, Pattern and Motivations. Adv Respir Med. 2017;85(1):8–14.
7. Brożek G, Jankowski M, Zejda J, Jarosińska A, Idzik A, Bańka P. E-Smoking among Students of Medicine—Frequency, Pattern and Motivations. Adv Respir Med. 2017 Feb 13;85(1):8–14.
8. Musawnaq FY, Zoghby AK, Al saqqaf AA, Alblwiy NA, Alhejaili FF, AlQurayyan AA, et al. The prevalence of the use of electronic smoking devices among medical students in Madinah. Med Sci. 2023 Jul 21;27(137):1–14.
9. Ahmed K, Alkabli S, Alawaji R, Almutairi A, Albarrak Y, Alammari A. Prevalence of Tobacco Consumption Through Passive Smoking and E-cigarette at Fakeeh College for Medical Sciences. Journal of Healthcare Sciences. 2021;02(02):31–6.
10. Jeon C, Jung KJ, Kimm H, Lee S, Barrington-Trimis JL, McConnell R, et al. E-cigarettes, conventional cigarettes, and dual use in Korean adolescents and university students: Prevalence and risk factors. Drug Alcohol Depend. 2016 Nov;168:99–103.
11. Wan Puteh SE, Abdul Manap R, Maharani H, Ahmad IS, Idris IB, Md Sham F, et al. The use of e-cigarettes among university students in Malaysia. Tob Induc Dis. 2018 Dec 10;16(December).
12. Katz SJ, Cohen EL, Kinzer HT. “Can I hit that?” Vaping knowledge, attitudes and practices of college students. Journal of American College Health. 2022 Aug 18;70(6):1778–87.
13. Johnson AC, Mays D, Hawkins KB, Denzel M, Tercyak KP. A qualitative study of adolescent perceptions of electronic cigarettes and their marketing: Implications for prevention and policy. Children’s Health Care. 2017 Oct 2;46(4):379–92.
14. Rohde J, Noar S, Horvitz C, Lazard A, Cornacchione Ross J, Sutfin E. The Role of Knowledge and Risk Beliefs in Adolescent E-Cigarette Use: A Pilot Study. Int J Environ Res Public Health. 2018 Apr 23;15(4):830.
15. Tackett AP, Wallace SW, Smith CE, Turner E, Fedele DA, Stepanov I, et al. Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users. Tob Use Insights. 2021 Jan 30;14.
16. Jankowski M, Wrześniewska-Wal I, Ostrowska A, Lusawa A, Wierzba W, Pinkas J. Perception of Harmfulness of Various Tobacco Products and E-Cigarettes in Poland: A Nationwide Cross-Sectional Survey. Int J Environ Res Public Health. 2021 Aug 20;18(16):8793.
17. Shaikh A, Ansari HT, Ahmad Z, Shaikh MY, Khalid I, Jahangir M, et al. Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan. Cureus. 2017 Jul 13;
18. Alzalabani AA, Eltaher SM. Perceptions and reasons of E-cigarette use among medical students: an internet-based survey. Journal of the Egyptian Public Health Association. 2020 Dec 17;95(1):21.
19. Afzal M, Ellis-Parkinson M, Holdsworth L, Sykes D, Crooks M. Electronic cigarette use and perceptions amongst UK medical students: A cross-sectional study. Tob Prev Cessat. 2021 Feb 22;7(February):1–3.
20. Sheikh E, Kumar A. Knowledge, attitude and practice of smoking vape among medical students in Karachi, Pakistan. In: Tobacco, smoking control and health education. European Respiratory Society; 2023. p. PA5330.
21. Hartono R, Yan C, Chen Y, Ma B, Deng Y, Sun Y, et al. Knowledge, attitude, and practice of e-cigarette use among undergraduate students: A comparative study between China and Indonesia. Tob Induc Dis. 2024 Jul 16;22(July):1–12.
22. Donaldson CD, Fecho CL, Ta T, Vuong TD, Zhang X, Williams RJ, et al. Vaping identity in adolescent e-cigarette users: A comparison of norms, attitudes, and behaviors. Drug Alcohol Depend. 2021 Jun;223:108712.
2. Keenan M, Keenan K, Wrotniak B, Qiao H, Emborsky M. Do Your Kids Vape? Pediatr Emerg Care. 2022 Jun;38(6):e1309–13.
3. Goh YH, Dujaili JA, Blebil AQ, Ahmed SI. Awareness and use of electronic cigarettes: Perceptions of health science programme students in Malaysia. Health Educ J. 2017 Dec 28;76(8):1000–8.
4. Sutfin EL, McCoy TP, Morrell HER, Hoeppner BB, Wolfson M. Electronic cigarette use by college students. Drug Alcohol Depend. 2013 Aug;131(3):214–21.
5. Hadland SE, Chadi N. Through the Haze: What Clinicians Can Do to Address Youth Vaping. Journal of Adolescent Health. 2020 Jan;66(1):10–4.
6. Brożek G, Jankowski M, Zejda J, Jarosińska A, Idzik A, Bańka P. E-Smoking Among Students of Medicine—Frequency, Pattern and Motivations. Adv Respir Med. 2017;85(1):8–14.
7. Brożek G, Jankowski M, Zejda J, Jarosińska A, Idzik A, Bańka P. E-Smoking among Students of Medicine—Frequency, Pattern and Motivations. Adv Respir Med. 2017 Feb 13;85(1):8–14.
8. Musawnaq FY, Zoghby AK, Al saqqaf AA, Alblwiy NA, Alhejaili FF, AlQurayyan AA, et al. The prevalence of the use of electronic smoking devices among medical students in Madinah. Med Sci. 2023 Jul 21;27(137):1–14.
9. Ahmed K, Alkabli S, Alawaji R, Almutairi A, Albarrak Y, Alammari A. Prevalence of Tobacco Consumption Through Passive Smoking and E-cigarette at Fakeeh College for Medical Sciences. Journal of Healthcare Sciences. 2021;02(02):31–6.
10. Jeon C, Jung KJ, Kimm H, Lee S, Barrington-Trimis JL, McConnell R, et al. E-cigarettes, conventional cigarettes, and dual use in Korean adolescents and university students: Prevalence and risk factors. Drug Alcohol Depend. 2016 Nov;168:99–103.
11. Wan Puteh SE, Abdul Manap R, Maharani H, Ahmad IS, Idris IB, Md Sham F, et al. The use of e-cigarettes among university students in Malaysia. Tob Induc Dis. 2018 Dec 10;16(December).
12. Katz SJ, Cohen EL, Kinzer HT. “Can I hit that?” Vaping knowledge, attitudes and practices of college students. Journal of American College Health. 2022 Aug 18;70(6):1778–87.
13. Johnson AC, Mays D, Hawkins KB, Denzel M, Tercyak KP. A qualitative study of adolescent perceptions of electronic cigarettes and their marketing: Implications for prevention and policy. Children’s Health Care. 2017 Oct 2;46(4):379–92.
14. Rohde J, Noar S, Horvitz C, Lazard A, Cornacchione Ross J, Sutfin E. The Role of Knowledge and Risk Beliefs in Adolescent E-Cigarette Use: A Pilot Study. Int J Environ Res Public Health. 2018 Apr 23;15(4):830.
15. Tackett AP, Wallace SW, Smith CE, Turner E, Fedele DA, Stepanov I, et al. Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users. Tob Use Insights. 2021 Jan 30;14.
16. Jankowski M, Wrześniewska-Wal I, Ostrowska A, Lusawa A, Wierzba W, Pinkas J. Perception of Harmfulness of Various Tobacco Products and E-Cigarettes in Poland: A Nationwide Cross-Sectional Survey. Int J Environ Res Public Health. 2021 Aug 20;18(16):8793.
17. Shaikh A, Ansari HT, Ahmad Z, Shaikh MY, Khalid I, Jahangir M, et al. Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan. Cureus. 2017 Jul 13;
18. Alzalabani AA, Eltaher SM. Perceptions and reasons of E-cigarette use among medical students: an internet-based survey. Journal of the Egyptian Public Health Association. 2020 Dec 17;95(1):21.
19. Afzal M, Ellis-Parkinson M, Holdsworth L, Sykes D, Crooks M. Electronic cigarette use and perceptions amongst UK medical students: A cross-sectional study. Tob Prev Cessat. 2021 Feb 22;7(February):1–3.
20. Sheikh E, Kumar A. Knowledge, attitude and practice of smoking vape among medical students in Karachi, Pakistan. In: Tobacco, smoking control and health education. European Respiratory Society; 2023. p. PA5330.
21. Hartono R, Yan C, Chen Y, Ma B, Deng Y, Sun Y, et al. Knowledge, attitude, and practice of e-cigarette use among undergraduate students: A comparative study between China and Indonesia. Tob Induc Dis. 2024 Jul 16;22(July):1–12.
22. Donaldson CD, Fecho CL, Ta T, Vuong TD, Zhang X, Williams RJ, et al. Vaping identity in adolescent e-cigarette users: A comparison of norms, attitudes, and behaviors. Drug Alcohol Depend. 2021 Jun;223:108712.