Tobacco cigarettes smoking and e-cigarettes using among university students: a cross-section survey in Guangzhou, China, 2021

Abstract Background There is an increase in the use of nicotine products worldwide, and similar trends may be observed in young adults. Cigarettes are consumed most heavily in China. However, there is limited information about Chinese nicotine product users and trends in nicotine product use among university students. Therefore, our objectives were to investigate the using status of nicotine products and smoking behavior among the students from 7 universities in Guangzhou, China. Methods Students at 7 different universities in Guangzhou were surveyed online in 2021 through a cross-sectional survey. A total of 10008 students were recruited and after screening, 9361 participants were adopted in our statistics. Descriptive analysis, Chi-square analysis, and multivariate logistic regression analysis were used to explore the smoking status and influencing factors. Results A total of 58.3% of participants were male. 29.8% of the participants used nicotine products. The average age of the 9361 university students was 22.4 years (SD = 3.6). Among the users of nicotine products, 16.7% were e-cigarettes only users, 35.0%were tobacco cigarettes only users, and 48.3% were dual users. Males were more likely to use nicotine products. Medical students, students from prestigious Chinese universities, and students with higher levels of education were less likely to use nicotine products. Similarly, students with unhealthy lifestyles (e.g., drinking alcohol, playing games excessively, staying up late) were more likely to use nicotine products. Emotion can have significant impacts on both tobacco cigarettes and e-cigarettes dual users when choosing nicotine products to use. More than half of dual users said they would choose tobacco cigarettes when they were depressed and e-cigarettes when they were happy. Conclusion We identified factors influencing the use of nicotine products among university students in Guangzhou, China. Gender, education level background, specialization, lifestyle habits and emotion all influenced the use of nicotine products among university students in Guangzhou, China. Male, low education level, from non-prestigious Chinese universities or vocational schools, non-medical specialization, and presence of unhealthy lifestyles were susceptibility factors for the use of tobacco cigarettes and e-cigarettes among university students in Guangzhou. Besides, emotions can influence dual users' choice of products.