LAUSR

Background: Electronic nicotine delivery systems (ENDS) continue in popularity among young adults. These devices are often advertised as a healthy alternative to quitting tobacco cigarettes. However, young adults represent a population who view it as a novel behavior that provides a sense of being cool, fitting in, and desired physiologic properties. The objective of this study was to examine characteristics of vaping behavior among college students and explore possible associations between groups of vaping behavior (stopped, initiated, increased, decreased, stayed the same).Methods: In a multicenter cross-sectional study, 656 students from University of Tampa (UT) in the United States and IST-University Applied Sciences in Germany (IST) were recruited to answer a 31-item online questionnaire. A Chi2 test was used to evaluate associations between the groups.Results: Prevalence rates indicated approximately 31% of all students were currently using ENDS. Even though more negative than positive experiences with ENDS were reported, most students stated their vaping increased during Covid-19 lockdowns. Addiction and stress relief emerged to be predictors (p < .001) of an increase in vaping, while social motives were not statistically significant. Living situation (p = .625) and depression (p = .096) were not significantly associated with vaping behavior.Conclusion: ENDS products continue to yield very high levels of nicotine creating addiction in young adults. Addiction counseling and evidenced based practices should be employed at every level (individual, community, and school). Additionally, mental health counseling for students in pandemic and high stress environments may help to combat stress in a more proactive manner than self-medicating.