Prevalence and Behavioral Trends of Electronic Nicotine Delivery System Use Among Youth in Tripoli, Libya

The rapid global increase in Electronic Nicotine Delivery Systems (ENDS) use among youth represents a critical public health challenge. However, there is a complete absence of city-level epidemiological data from Libya. This study aimed to determine the prevalence, patterns, and predictors of ENDS use among students in Tripoli. A cross-sectional online survey was administered to a sample of 420 students aged 15–25 years in Tripoli, Libya. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression in IBM SPSS version 28. The lifetime prevalence of ENDS use was 44.0% (95% CI: 39.3–48.9). The current (past 30-day) prevalence of use was 20.5% (95% CI: 16.8–24.6). Current use was significantly higher among males (31.3%) than among females (5.6%). Male was the sole strong independent demographic predictor (Adjusted Odds Ratio = 8.41, 95% CI: 4.07–17.37). The primary motivation for use was curiosity or experimentation (73.3%). While 82.6% of current users expressed a desire to quit, 33.7% reported physical difficulty abstaining for 24 hours. This first city-level study reveals alarmingly high ENDS use among youth in Tripoli, characterized by a pronounced gender disparity and primarily experimental motivations. These findings highlight an urgent need for targeted prevention, cessation support, and specific regulatory action in Libya