Knowledge and Risk Perception of E-cigarettes and Hookah Among Youths in Anambra State, Nigeria

Background E-cigarettes and hookah have gained significant popularity, particularly among young people in recent years, despite limited research on their safety and efficacy. Advertisements for these products are widespread across various media platforms, further increasing their popularity and raising awareness among youths. This study aimed to assess the knowledge and risk perception of e-cigarettes and hookah among youths in Anambra State, Nigeria. Method This descriptive cross-sectional study was conducted in three tertiary institutions, selected through simple random sampling from the three Senatorial Districts of Anambra State. Participants (n = 272), aged 18–35 years, were recruited using a multi-stage stratified random sampling technique A self- administered, semi- structured questionnaires was shared amongst students of the three tertiary institutions that met the inclusion criteria. Descriptive statistics were generated, and chi-square tests were conducted to determine the level of significance at p < 0.05. Result The study showed that most participants (66.7%) reported the internet/media as their primary source of information about these substances. Majority (64.7%) perceived both e-cigarettes and hookah as equally harmful in terms of health risks, while 50.7% considered both substances equally addictive. Participants identified respiratory (65.4%) and cardiovascular (71.7%) diseases as the major health risks associated with e-cigarette and hookah use. Most users of these substances were within the 25–29 age group, and 7.4% of participants reported using both e-cigarettes and hookah. The majority of first-time users tried these devices in cafés/restaurants, followed by nightclubs. Conclusion This study demonstrates high awareness but limited comprehensive knowledge of the health risks associated with e-cigarette and hookah use among youths in Anambra State. The prevalence of use in social settings reveals the need for targeted education on their risks. Incorporating these products into smoke-free policies and regulating access in youth-centered environments are essential to curbing their growing use and associated health risks.