# Use of and Beliefs toward Novel Tobacco and Nicotine Products among Portuguese University Students: A Pandemic Survey

## TL;DR

A survey of Portuguese university students found high rates of tobacco and nicotine product use, with many using multiple products and holding pro-smoking beliefs.

## Contribution

The study provides new insights into nicotine product use and beliefs among Portuguese university students during the pandemic.

## Key findings

- 60.4% of students reported experimenting with tobacco or nicotine products.
- Being male, in the third year of study, and socializing with smokers were linked to higher use.
- Few users were ready to quit, and few supported smoke-free campuses.

## Abstract

Over the last decade, novel tobacco and nicotine product experimentation and use have dramatically increased among the youth, even in countries with strong tobacco control and anti-smoking social norms. We performed an online questionnaire-based cross-sectional study in March-June 2021, targeting students from the University of Beira Interior, Portugal. The aim was to assess the experimentation and use of tobacco and nicotine products and students’ beliefs towards these products. Of the 452 participants, 67.0% were female; the mean age was 21.9 ± 3 years. Most students (60.4%) reported experimenting with tobacco/nicotine products; 31.2% were current users; polyconsumption was common. Of the current users, all used cigarettes, 41.1% used heated tobacco, 20.6% e-cigarettes, and 14.9% used water pipes. Our multivariate analysis showed that being male, being in the third year of study, and cohabiting or socializing with smokers were strongly associated with tobacco/nicotine use. While most students agree that heated tobacco and e-cigarettes are addictive, that they are not less harmful than cigarettes, and that second-hand exposure may cause health problems, few tobacco/nicotine users are ready to quit, and few students support a smoke-free university campus. These findings indicate high experimentation and the regular dual use of novel tobacco and nicotine products and suggest a pro-smoking social norm among university students.