Awareness, knowledge, perceptions, and use of electronic cigarettes and heated tobacco products among adults attending a university hospital: A cross-sectional study

OBJECTIVE:The aim of this study was to evaluate awareness, knowledge, perceptions, and use of electronic cigarettes and heated tobacco products (HTPs) among adults attending a university hospital and to identify independent factors associated with ever use of these products. METHODS:This cross-sectional study included 384 adults aged ≥18 years attending the outpatient clinics of a university hospital in Turkiye.Data were collected using a structured questionnaire assessing sociodemographic characteristics, smoking status, awareness, knowledge, perceptions, and use of electronic cigarettes and HTPs.Descriptive statistics, Chi-square and Mann-Whitney U-tests, and multivariable logistic regression analyses were performed to identify factors independently associated with ever use of electronic cigarettes and HTPs.RESULTS: Awareness of electronic cigarettes was substantially higher than that of HTPs (90.4% vs. 37.5%), while ever use was reported by 38.0% and 10.4% of participants, respectively.More than half of the participants lacked knowledge regarding the harmfulness, addictiveness, legal status, and smoking cessation role of HTPs.Current smokers were significantly more likely than non-smokers to perceive electronic cigarettes and HTPs as less harmful, less addictive, and useful for smoking cessation (all p<0.05).In multivariable logistic regression analyses, increasing age was associated with lower odds of ever use of electronic cigarettes (adjusted odds ratio [AOR]: 0.91,95% confidence interval [CI]: 0.89-0.94)and HTPs (AOR: 0.93, 95% CI: 0.89-0.97).Male sex (electronic cigarettes: AOR: 3.85, 95% CI: 2.18-6.82;HTPs: AOR: 2.65, 95% CI: 1.25-5.62)and current cigarette smoking (electronic cigarettes: AOR: 10.41, 95% CI: 5.57-19.46;HTPs: AOR: 3.88, 95% CI: 1.77-8.49)were independently associated with ever use of both products. CONCLUSION:Although awareness of electronic cigarettes was high, awareness of HTPs was considerably lower, and substantial knowledge gaps and misconceptions regarding HTPs persisted.Current smokers were more likely to hold favorable perceptions of both products, and younger age, male sex, and current cigarette smoking were independently associated with ever use.These findings underscore the need for evidence-based public health interventions to improve public knowledge, correct misconceptions regarding the harmfulness and smoking cessation role of these products, and support tobacco control strategies aimed at preventing the uptake of emerging tobacco products.