“Prevalence and socio-demographic predictors of smoking, e-cigarette use, and nicotine dependence among college students in Chittoor district, Andhra Pradesh: A cross-sectional study”

<h2>Abstract</h2><h3>Objectives</h3> To estimate the prevalence of smoking, with a focus on e-cigarette use and nicotine dependence, among college-going students in Chittoor district, Andhra Pradesh. Additionally, it identified socio-demographic predictors of smoking, e-cigarette use, and nicotine dependence. <h3>Methods</h3> A cross-sectional study was conducted among undergraduate students from seven randomly selected colleges in Chittoor district, Andhra Pradesh, between January 2023 and June 2024. A multi-stage sampling method was used to recruit 694 participants. Data were collected using a structured, pre-tested, self-administered questionnaire. Risk was assessed by adjusted odds ratio (aOR) with 95 % confidence interval (CI). Nicotine dependence was assessed using the Fagerström Nicotine Dependence Scale. <h3>Results</h3> The mean age of participants was 21.6 years (SD 2.3), with 39.5 % (95 % CI: 35.8–43.2) reporting any form of smoking in the preceding month. E-cigarette use was reported by 16.4 % (95 % CI: 13.6–19.2), while 31.1 % (95 % CI: 27.6–34.6) engaged in traditional smoking. Male gender (aOR: 7.4), age ≥20 years (aOR: 3.0), higher family income (aOR: 5.5), and family history of smoking (aOR: 319.4) were significant predictors of e-cigarette use. Nicotine dependence was observed in 14.2 % of smokers, with family history of smoking being a major risk factor (OR: 2.5). <h3>Conclusion</h3> Smoking prevalence, including e-cigarette use, is alarmingly high among college students in Chittoor district. Male students from affluent backgrounds and those with a family history of smoking are at higher risk. Colleges could be potential places for targeted public health interventions to mitigate nicotine dependence and its associated risks among the young populations.