Prevalence, knowledge, attitude, and practice of vaping among university students in the United Arab Emirates: a cross-sectional study

Background: Electronic cigarette use is increasing among young adults worldwide, yet data from the Middle East remain limited. Understanding whether vaping behavior is driven more by knowledge or attitudes has implications for prevention strategies. This study aimed to determine the prevalence of vaping among university students in the United Arab Emirates (UAE), assess their knowledge of vaping-related risks, explore attitudes and practices toward e-cigarette use, and identify factors associated with vaping initiation and continuation. Methods: The study was conducted among university students in the UAE between April 2024 and November 2025. All students aged 18 years and above were eligible to participate. Data were collected using a structured questionnaire incorporating the Electronic Cigarette Knowledge Questionnaire (ECQ), the Electronic Cigarette Attitude Scale (ECAS), and the Penn State Electronic Cigarette Dependence Index (PS-ECDI). Descriptive statistics were used to summarize participant characteristics, while multivariate logistic regression identified factors associated with current e-cigarette use. Results: Among 422 participants (mean age = 21.5 years ± SD = 4.9; 72.7% female), 99 students (23.5%) reported current e-cigarette use. Knowledge levels were generally low to moderate (mean ECQ score, 8.16 ± 3.62 of 17), with only 3.4% demonstrating high knowledge. Among current users, 51.5% exhibited low nicotine dependence, while 41.5% showed moderate to high dependence. In multivariable analyses, higher positive attitude scores were associated with greater odds of e-cigarette use [adjusted odds ratio (Aor), 1.24; 95% CI, 1.16-1.33; P < 0.001], whereas sociodemographic characteristics and knowledge level were not significantly associated with current use. Conclusion: Vaping is common among UAE university students, with a notable proportion exhibiting nicotine dependence. Targeted educational and campus-based interventions are needed to address misconceptions and reduce vaping-related harms.