Three-Time Survey Comparison of Tobacco and E-Cigarette Use and Perceptions Among College Students

Background/Objectives: Tobacco use among young adults remains a public health concern. Understanding trends in tobacco and e-cigarette use may help inform future education and intervention strategies. This survey aims to assess tobacco and e-cigarette use and related perceptions over a 5-year period. Methods: A validated 33-item questionnaire was sent to students at a Midwestern university in Fall 2018, 2020, and 2023. The survey assessed tobacco use, e-cigarette use, and perceptions. Results: A total of 8143 student responses were collected over the 5-year period. A total of 3850 students participated in 2018, 1743 in 2020, and 2550 in 2023. Current traditional cigarette use declined over time (6.1%, 3.2%, 4.2%, respectively), while e-cigarette use decreased but remained the most common product (22.9%, 23.1%, 18.8%, respectively). Disagreement with the statements that imply e-cigarettes are a safe or effective option to quit smoking, and agreement with the stance that e-cigarettes are addictive, all increased during the 5-year period. Conclusions: These survey findings suggest a decrease in self-reported tobacco and e-cigarette consumption over the 5-year study period. Continued surveillance of local alongside national and global systems remains essential to determine whether specific sub-populations mirror the broader use patterns.