Electronic cigarettes (e-cigarettes) are an emerging global public health threat. In Palestine, tobacco
use poses a significant challenge, but little is known about the prevalence of e-cigarette use and
Palestinians’ knowledge and perceptions of e-cigarettes. A cross-sectional study was conducted
between 02/05/2024 and 16/06/2024 using a questionnaire composed of three sections. The first
section collected sociodemographic data. The second section focused on the participants’ sources of
information about e-cigarettes and their current smoking status. The third section was designed to
evaluate participants’ knowledge and perceptions of e-cigarettes. The questionnaire was distributed
through online platforms to Palestinians aged 18 years and above. Among the total number of 1160
participants, 14.9% were e-cigarette users. Out Of the 173 e-cigarette users, 45.7% were dual users
of tobacco and e-cigarettes, and 20.8% had replaced tobacco with e-cigarettes. There was significant
variation between e-cigarette users and non-users in terms of sex and age. Moreover, there were
significant variations between the reported level of knowledge about e-cigarettes and all of the
assessed knowledge and perception in terms of e-cigarette users and non-users (p-value < 0.05). More
than 60.0% of the participants agreed that e-cigarettes contain nicotine and carcinogenic substances.
More than half of the participants disagreed with the statement that e-cigarettes are safe to use
compared to cigarettes. 17.2% of the participants agreed that using e-cigarettes can aid in smoking
cessation. 41.9% of the participants thought that e-cigarettes are cost-effective compared with
cigarettes. Additionally, the presence of nicotine in e-cigarettes had a significant positive association
with using e-cigarettes, while the presence of carcinogenic compounds in e-cigarettes had a significant
negative association with using e-cigarettes. Disagreement about the greater safety of e-cigarette
use compared to cigarettes, and support for the application of regulations on e-cigarette use had
significant negative associations with using e-cigarettes. E-cigarette use is a growing and overlooked
public health threat among Palestinians. Immediate actions are needed not only to increase awareness
of e-cigarettes, but also to implement stricter regulations on their availability.

Title

Scientific Reports

Publisher

Nature Portfolio

Publisher Country

United Kingdom

Indexing

Scopus

Impact Factor

3.9

Publication Type

Prtinted only

Volume

15

Year

2025

Pages

14