Prevalence, Risk Factors, Harm, Perception and Attitudes Toward E-Cigarette Use Among Athletes in Lebanon:A Cross-Sectional Study

Background The rising prevalence of e-cigarette use among athletes globally and in the Middle East and North Africa (MENA) region including Lebanon, poses significant public health concerns. Objective This study investigates e-cigarette use patterns, knowledge, perceptions, and influences among athletes in Lebanon. Methods A cross-sectional survey was conducted in Arabic and English among 563 athletes aged 19–22 years, from July to December 2024. A self-reported questionnaire was adapted. Descriptive univariate analyses were performed, followed by bivariate analyses to examine the association between e-cigarette use and the variables of interest. Additionally, binary logistic regression analysis was conducted to identify the determinants of e-cigarette use among the students. Results E-cigarette use was predominantly social, occurring in homes and cafes. While most of the participants recognized that e-cigarettes could cause lung cancer, only a few believed they were less harmful than traditional cigarettes. Key influences on use included peer pressure, advertisements, stress relief, and curiosity. Conclusion Despite awareness of health risks, e-cigarette use remains widespread among athletes, emphasizing the need for targeted awareness campaigns and stricter regulations to address misconceptions and reduce usage rates in this high-risk population.