Abstract
Nursing students trained to be health advocates have engaged in cigarette and electronic cigarette (EC) use. Our study aimed to determine the prevalence of cigarette and EC use among nursing students and examine how EC vaping and cigarette smoking are associated with various risk factors. This cross-sectional survey of smoking and vaping was administered to 249 nursing students in a private university in Manila, Philippines. An online-based self- assessment questionnaire (SAQ) that includes socio-demographic information, cigarette and EC usage, Perceived Stress Scale (PSS), and other risk factors was administered using on-campus and online recruitment strategies. Generalized linear models were fitted to estimate the effect of stress and other risk factors on smoking and vaping. Approximately one out of eight were exclusive vapers, one out of 25 were exclusive smokers, and one out of five were both smokers and vapers. The prevalence of smoking/vaping was 47% higher [adjusted prevalence ratio (aPR): 1.47, 95% confidence interval (95% CI): 1.04–2.07, p-value = 0.028] among students with high-stress levels than students with low to moderate stress levels. In addition, students who were sophomores (aPR: 1.69, 95% CI: 1.12–2.53, p-value = 0.012), juniors (aPR: 3.22, 95% CI: 1.91–5.42, p-value < 0.001), and seniors (aPR: 1.53, 95% CI: 0.76–3.08, p-value = 0.230) had a higher prevalence of smoking/vaping compared to freshmen students. Having a positive attitude towards vaping health impacts and a smoker/vaper peer was also associated with a higher prevalence of smoking/vaping. Therefore, effective health communication strategies and policies in universities and the community are recommended to reinforce existing smoking and vaping control efforts.
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