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Impact of E-Cigarette Awareness Education on E-Cigarette Risk Knowledge among University Students in Nigeria

Abstract

Electronic cigarette (e-cigarette) use has emerged as an important public health concern, particularly among adolescents and young adults, as awareness and availability of vaping products continue to increase. University students may be exposed to e-cigarette marketing, social influences, peer use, and misconceptions that portray vaping as harmless or substantially risk-free. Limited knowledge of the potential health risks associated with e-cigarettes, nicotine dependence, exposure to harmful chemicals, respiratory effects, and the risks of dual use with conventional cigarettes may affect informed health decisions among young adults. E-cigarette awareness education provides an opportunity to improve students' understanding of vaping-related risks and correct misconceptions about the safety of e-cigarette use. Against this background, this study investigates the impact of e-cigarette awareness education on e-cigarette risk knowledge among university students in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Literacy Framework. The Health Belief Model explains how students' perceptions of their susceptibility to e-cigarette-related harm, perceived severity of potential health consequences, perceived benefits of avoiding harmful use, perceived barriers, and cues to action may influence their risk knowledge and health-related decisions. Social Cognitive Theory emphasizes observational learning, peer influence, self-efficacy, behavioural reinforcement, and environmental factors in shaping knowledge and health behaviours. The Health Literacy Framework emphasizes students' ability to access, understand, evaluate, and apply health information when making informed decisions about e-cigarette use. Collectively, these theoretical perspectives provide a suitable framework for explaining how e-cigarette awareness education may influence e-cigarette risk knowledge among university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate students enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, and eligible students. E-cigarette awareness education will be assessed using indicators such as exposure to structured educational sessions, frequency and duration of education, information on e-cigarette components, nicotine content, potential health effects, dependence, respiratory risks, chemical exposure, dual use with conventional cigarettes, second-hand aerosol exposure, misconceptions about vaping, marketing influences, and available cessation or support services. E-cigarette risk knowledge will be assessed using indicators such as knowledge of nicotine dependence, awareness of potential respiratory and cardiovascular effects, understanding of chemical exposure, recognition of risks associated with dual use, awareness of second-hand aerosol exposure, understanding of risks to young people, knowledge of addiction potential, and ability to distinguish evidence-based information from common misconceptions about e-cigarettes. Data will be collected using structured questionnaires, validated e-cigarette knowledge instruments, educational programme attendance records, and relevant university health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to e-cigarette awareness education, and risk knowledge scores. 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 awareness education on e-cigarette risk knowledge. Where a quasi-experimental design is adopted, risk knowledge scores before and after the educational intervention may be compared to determine changes associated with the programme. 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 awareness education has a significant positive impact on e-cigarette risk knowledge among university students in Nigeria. Students exposed to structured and evidence-based education are expected to demonstrate improved understanding of nicotine dependence, potential respiratory and cardiovascular risks, harmful chemical exposure, dual-use risks, and the limitations of claims that e-cigarettes are harmless. Interactive education, peer-led discussions, digital health campaigns, and scenario-based learning may improve students' ability to identify misleading information and make informed decisions regarding vaping. Education may also increase awareness of nicotine addiction and encourage students who use e-cigarettes to seek appropriate health information and cessation support. However, exposure to social media marketing, peer influence, misconceptions, product accessibility, and conflicting information about the relative risks of e-cigarettes may affect students' understanding. The study therefore expects accessible, evidence-based, age-appropriate, and regularly reinforced e-cigarette awareness education to contribute significantly to improved e-cigarette risk knowledge among university students in Nigeria. The study is expected to contribute to the literature on e-cigarette awareness education, e-cigarette risk knowledge, vaping, nicotine use, university student health, tobacco control, health education, substance-use prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Agency for Food and Drug Administration and Control, Nigeria Centre for Disease Control and Prevention, universities, university health services, tobacco-control organizations, public health educators, student organizations, development partners, and policymakers regarding strategies for improving awareness of e-cigarette-related health risks among young adults. The study will also provide evidence-based recommendations for integrating e-cigarette risk education into university health programmes, strengthening tobacco and nicotine prevention campaigns, improving digital health communication, addressing vaping-related misconceptions, and developing appropriate health education strategies for university students across Nigeria.

Keywords: E-cigarette awareness education, e-cigarette risk knowledge, electronic cigarettes, vaping, nicotine, university students, tobacco control, health education, substance-use prevention, Nigeria, public health.