Awareness, perceptions, and use of e-cigarettes among medical university students in Tbilisi, Georgia

The e-cigarette industry has targeted low- and middle-income countries and young adults, suggesting the particular susceptibility of populations at the intersection. This study assessed e-cigarette perceptions, use, and use intention among college students in Georgia, an LMIC with high smoking rates. We analyzed 2023 cross-sectional survey data among 225 students (M_age = 21.68, SD = 3.43; 56.4% female) at a large medical university in Tbilisi, Georgia. Multivariable regression analyses assessed sociodemographics, tobacco use, and e-cigarette perceptions in relation to past-month e-cigarette use and next-year use intentions. Past-month use of cigarettes and e-cigarettes was 44.9% and 23.3%, respectively. The most common sources of initial exposure were friends/family (72.2%), followed by media (25.6%). The most common reasons for initiation were curiosity (49.6%), friends’ use (28.5%), cigarette cessation (15.5%), and lower perceived risk versus cigarettes (2.4%). Past-month e-cigarette use was associated with past-month cigarette use (p < .001), being more informed about e-cigarettes (p = .001), and more favorable e-cigarette perceptions (p = .009). Greater next-year e-cigarette use intent was associated with past-month e-cigarette use and perceiving e-cigarettes as less of a public health problem (p = .029). Enhanced regulatory and educational efforts must address e-cigarette use and related factors among young adults in Georgia and countries with similar contexts.