Perception and Use of E-Cigarettes Among Different Age Groups in the General Population of Peshawar, Pakistan: A Cross-Sectional Study

Background: The global use of e-cigarettes has risen significantly, often fueled by the perception that they are a safer alternative to conventional cigarettes. Despite this belief, emerging evidence raises concerns about their health risks. This study investigates the perceptions and patterns of e-cigarette use across different age groups in Peshawar, Pakistan. Objective: To explore the perceptions and frequency of e-cigarette use among various age groups in Peshawar. Methodology: A cross-sectional study was conducted from August 2023 to February 2024 among the general population in Peshawar. A total of 384 participants were selected using a non-probability convenience sampling technique. Data were collected using a pre-tested structured questionnaire and analyzed with SPSS version 26. Ethical approval was obtained from the Research and Ethics Committee of Pak International Medical College, Peshawar. Results: Of the 384 participants, 322 (83.86%) were male and 62 (16.14%) were female. The majority of respondents belonged to the 18–29 age group. The mean age of the study population was 35 ± 4.5 years. Most participants had a Bachelor's or Master's degree (70%), 38.5% were professionals, and 29.7% had a monthly income exceeding 60,000 PKR. Awareness of e-cigarettes was high (90.1%), with 39.3% identified as users—53% of whom reported daily use. Notably, 10.4% believed that e-cigarettes are not harmful at all, while 39.1% considered them less harmful than conventional cigarettes. Conclusion: This study revealed a high level of awareness and usage of e-cigarettes among young individuals, particularly males, in Peshawar. The perception that e-cigarettes are less harmful than traditional cigarettes is concerning and highlights the need for targeted awareness campaigns. Despite some knowledge of associated health risks, many individuals continue to use e-cigarettes, often under the impression that they are a safer alternative. Further research and policy measures are essential to address this growing public health concern. Keywords: E-cigarettes, Perception, Public health, Smoking, Youth.