ENDS consumption in students of higher education: Phenomenon on the rise during the COVID-19 pandemic

Being male, aged <26 years, having a history of substance use, having tried conventional cigarettes, pandemic tobacco use, and having lived with other ENDS users, were the main factors associated with pandemic ENDS use. Studying the consumption habits of students in response to lifestyle changes, is fundamental for the formulation of strategies to reduce the development of addictive behaviors, especially in young students during the pandemic.

This study employed a cross-sectional analytical design, based on a self-administered online survey, conducted in 2021, among students aged 18-59 years. The sample size was 3985 students. Statistical analysis was done through frequency studies, hypothesis testing and a multivariate-penalized logistic regression model (firthlogit), based on the Akaike information criterion (AIC).

A total of 3573 students completed the survey, 61.5% were female, 55.3% were young (aged 18-26 years), and 44.6% were adults (aged 27-59 years). The prevalence of ENDS use during the pandemic was 7.3%. Age was negatively associated with ENDS use, as young people had a higher likelihood of using these devices. The likelihood of ENDS use was negative among females (OR=0.38; 95% CI: 0.2-0.5). In contrast, it was positive in students with a history of psychoactive substance abuse and/or dependence (OR=3.59; 95% CI: 1.0-12.0), students who had tried conventional cigarettes (OR=5.12; 95% CI: 3.0-8.5), participants who smoked tobacco during the pandemic (OR=3.15; 95% CI: 2.3-4.2), those who studied virtually (OR=1.52; 95% CI: 1.0-2.3), participants who lived with other ENDS users (OR=3.86; 95% CI: 2.8-5.2) and students with negative perception of impacts on their mental health (OR=1.48; 95% CI: 1.1-1.9). Conclusions: Being male, aged <26 years, having a history of substance use, having tried conventional cigarettes, pandemic tobacco use, and having lived with other ENDS users, were the main factors associated with pandemic ENDS use. Studying the consumption habits of students in response to lifestyle changes, is fundamental for the formulation of strategies to reduce the development of addictive behaviors, especially in young students during the pandemic.