Herbal or conventional medicine? A cross-sectional study of Jordanian university students’ preferences for cold and flu treatment

Background University students frequently self-manage common cold and influenza symptoms using herbal remedies, pharmaceutical treatments, or both. However, evidence regarding treatment preferences among Jordanian university students remains limited. Objective To assess treatment preferences and factors associated with four outcomes: first-line treatment choice, timing of treatment initiation, response to perceived herbal treatment failure, and medication-obtaining behavior. Methods An observational cross-sectional study was conducted in Jordan among 1,797 undergraduate students from 16 April to 16 September 2025 using a confidential, de-identified Arabic online questionnaire. Descriptive statistics and multinomial logistic regression were used to evaluate the four outcomes. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported. Results Combined therapy was the most common first-line choice (44.5%), and 42.5% initiated treatment on the same day. Female participants had higher odds of preferring combined therapy than males (aOR = 2.55, 95% CI: 1.64–3.96; p < 0.001), whereas medical-field students had lower odds of same-day treatment initiation (aOR = 0.55, 95% CI: 0.42–0.72; p < 0.001). After perceived herbal treatment failure, 50.7% switched to pharmaceutical treatments; reliance on doctor-prescribed treatments was associated with lower odds of continuing herbal remedies (aOR = 0.38, 95% CI: 0.27–0.51; p < 0.001) or combining herbal and pharmaceutical treatments (aOR = 0.56, 95% CI: 0.45–0.70; p < 0.001). Regarding medication-obtaining behavior, 28.2% purchased pharmaceutical treatments without a prescription based on personal experience, and medical-field students had higher odds of this behavior (aOR = 1.76, 95% CI: 1.39–2.23; p < 0.001). Conclusions Treatment decisions reflected frequent combined self-care and were associated with sex, field of study, symptoms, prescription-related behavior, and treatment beliefs. Targeted health education may support more informed and rational self-care among university students.