Understanding tobacco and e-cigarette use among university students: a cross-sectional study exploring nicotine dependence, quit intentions, and awareness of cessation support services.

OBJECTIVE: While tobacco addiction remains a preventable global public health issue, increasing concern surrounds the growing use of electronic cigarettes(e-cigarette) among young people. This study aimed to investigate the prevalence of tobacco and e-cigarette use, students' willingness to quit, their awareness of available professional counselling support, and their knowledge of e-cigarettes. METHODS: This cross-sectional study was conducted between March and June 2024 at a public university in Ankara, Turkey with participation of 1144 students. Stratified and cluster sampling methods were used. Data were collected via face-to-face questionnaires assessing sociodemographic characteristics, tobacco use behaviours, attempts to quit, the Fagerstrom Test for Nicotine Dependence, and 14 e-cigarette knowledge statements. Informational leaflets on cessation support and e-cigarette harms were provided to participants following the survey. RESULTS: Overall, 40.6% reported current use of any tobacco product and 24.3% reported e-cigarette use; among cigarette smokers, 74.4% had low/very low dependence (median 2 pack-years). Although 72.8% wished to quit, only 36.9% knew how to access medical counselling and 22.3% had received quit advice in the past year. In multivariable analyses, higher academic year, male gender, and lower perceived economic status were associated with greater odds of tobacco use, while female gender and studying in the Faculty of Medicine were associated with lower odds of tobacco use. E-cigarette use was primarily motivated by flavour, curiosity, and, to a lesser extent, smoking cessation. CONCLUSION: Tobacco product use remains widespread among university students, with a growing preference for new-generation products such as e-cigarettes. However, low nicotine dependence levels and high willingness to quit represent a valuable intervention opportunity. Comprehensive university-based programs focused on prevention, awareness, and smoking cessation support are essential to promote healthy lifestyle behaviours in young adults. TRIAL REGISTRATION: Not Applicable.