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Impact of E-Cigarette Health Education on E-Cigarette Risk Knowledge among Young Adults in Nigeria

Abstract

E-cigarette use has emerged as an important public health concern because electronic cigarettes and other vaping products may expose users to nicotine and other potentially harmful substances. Young adults may be particularly vulnerable to e-cigarette use because of peer influence, social media exposure, product marketing, curiosity, perceived social acceptability, and misconceptions that e-cigarettes are harmless or completely safe alternatives to conventional tobacco products. Limited knowledge of the potential health risks associated with e-cigarette use may influence young adults' perceptions and decisions regarding vaping. E-cigarette health education provides an opportunity to improve awareness of the potential health effects of vaping, nicotine dependence, exposure to harmful substances, and other risks associated with e-cigarette use. Against this background, this study investigates the impact of e-cigarette health education on e-cigarette risk knowledge among young adults in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Protection Motivation Theory. The Health Belief Model explains how young adults' perceptions of susceptibility to e-cigarette-related health problems, perceived severity, perceived benefits of avoiding e-cigarette use, perceived barriers, and cues to action may influence their understanding and health-related decisions. Social Cognitive Theory emphasizes observational learning, peer and social influences, behavioural modelling, self-efficacy, and environmental factors in shaping young adults' knowledge and attitudes toward e-cigarette use. Protection Motivation Theory explains how perceived threats, response efficacy, self-efficacy, and perceived response costs may influence individuals' motivation to understand and avoid health risks associated with vaping. Collectively, these theoretical perspectives provide a suitable framework for explaining how e-cigarette health education may influence e-cigarette risk knowledge among young adults in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise young adults aged 18–35 years residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, educational institutions, workplaces, and eligible young adults. E-cigarette health education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, knowledge of e-cigarette components, nicotine content, nicotine dependence, potential respiratory and cardiovascular risks, effects of vaping on young people, second-hand or aerosol exposure, misconceptions about e-cigarette safety, differences between e-cigarettes and conventional tobacco products, recognition of marketing claims, and awareness of available cessation or professional support services. E-cigarette risk knowledge will be assessed using indicators such as recognition of nicotine-related risks, understanding of dependence potential, awareness of respiratory and cardiovascular health concerns, knowledge of exposure to potentially harmful chemicals, understanding of risks associated with frequent use, awareness of potential effects of vaping during pregnancy where applicable, recognition of risks associated with dual use of e-cigarettes and conventional cigarettes, and ability to distinguish evidence-based information from common misconceptions about e-cigarettes. Data will be collected using structured questionnaires, standardized knowledge assessment instruments, health education attendance records, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic characteristics, e-cigarette exposure, sources of information, previous health education, and levels of e-cigarette risk knowledge. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of e-cigarette health education on e-cigarette risk knowledge. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that e-cigarette health education has a significant positive impact on e-cigarette risk knowledge among young adults in Nigeria. Young adults exposed to structured and evidence-based health education are expected to demonstrate greater knowledge of the potential risks associated with e-cigarette use than those without comparable exposure. Education may improve understanding of nicotine dependence, potentially harmful substances in e-cigarette aerosols, respiratory and cardiovascular health concerns, misconceptions surrounding vaping, and the risks associated with dual use of e-cigarettes and conventional tobacco products. Practical and interactive education may also improve young adults' ability to critically evaluate e-cigarette marketing messages and online information. However, peer influence, social media exposure, misleading promotional content, misconceptions about vaping, limited access to reliable health information, and the rapidly changing nature of e-cigarette products may reduce the effectiveness of health education alone. The study therefore expects accessible, evidence-based, age-appropriate, and continuous e-cigarette health education to contribute significantly to improved knowledge of e-cigarette risks among young adults in Nigeria. The study is expected to contribute to the literature on e-cigarette use, vaping, tobacco control, nicotine dependence, health education, risk communication, health promotion, substance-use prevention, youth and young-adult health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, Federal Ministry of Education, state ministries of health and education, universities, healthcare professionals, public health practitioners, tobacco-control organizations, community-based organizations, development partners, and policymakers regarding strategies for improving awareness of e-cigarette-related health risks. The study will also provide evidence-based recommendations for strengthening e-cigarette health education, integrating vaping-risk education into health-promotion programmes, improving public awareness of nicotine dependence and e-cigarette-related health concerns, addressing misinformation about vaping, strengthening tobacco and nicotine-use prevention initiatives, and developing appropriate health communication interventions for young adults across Nigeria.

Keywords: E-cigarette health education, e-cigarette risk knowledge, electronic cigarettes, vaping, young adults, nicotine dependence, tobacco control, health education, health promotion, Nigeria, public health.