A Cross-Sectional Study Evaluating the Knowledge, Attitudes, and Behaviors Related to Smoking Among University Students in Pakistan

Background: A global issue, tobacco use is on the rise among young people in Asian nations like Pakistan, especially among college students. This study's initial goal was to investigate smoking behaviors, attitudes, and smoking-related information among Pakistani students in different departments and colleges. Methods: A cross-sectional descriptive study was conducted in both urban and rural areas between February and April 2025. Data were acquired from Pakistani University's faculties as well as Community College departments. The questionnaire was based on the Global Health Professionals and Global Youth Tobacco Surveys. A total of 760 the students were randomly selected. Results: In the current study, 53 (27.3%) smokers scored very high on the FTND, making them predisposed to heavy smoking dependency. A linear regression analysis found a strong association between students' smoking knowledge and age, residency, smoking status, and geographic location (p<0.001). Significant indicators of smoking knowledge included sex, marital status, and school year (P<0.05). The study indicated that age, family income, marital status, and school-year level were significantly related to students' attitudes and perspectives on smoking (P<0.001). However, the study indicated that age >24 years and second and fourth school years were significantly connected to smoking behavior (P < 0.001). Students with positive attitude ratings had decreased rates of smoking dependency (P<0.05). Smokers exhibited more positive attitudes and views about smoking compared to nonsmokers, and nonsmokers had more smoking-related information (P<0.001). Students from various departments and colleges had significantly diverse knowledge levels on the detrimental impacts of smoking and hazardous tobacco components from cigarettes (P<0.001). Conclusions: The results of the FTND test demonstrated that smokers are highly dependent on smoking in this study. Smoking attitudes, knowledge, and dependence were all higher among fourth-year students. In contrast to nonsmokers, who were more cognizant of the harmful effects of smoking, smokers tended to have more favorable attitudes toward smoking. Departmental and college-level smoking data discrepancies highlight the need for targeted anti-smoking campaigns and enhanced public awareness of the risks associated with tobacco use.