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These social determinants are tobacco and tobacco products, indoor and outdoor pollution, occupational exposures, infections, low education and socioeconomic status, and poverty

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Similar patterns of regular use, limited awareness of nicotine content, and moderate to high dependence have been observed among university students in several Middle Eastern countries, suggesting that this issue is a regional concern rather than an isolated finding ( Together, these findings indicate that e-cigarette dependence among university students is driven by a combination of behavioral habits, nicotine exposure, and positive perceptions of vaping, rather than intentional addiction

Preventive measures: Do not smoke or use tobacco Avoid second-hand smoke Maintain a healthy lifestyle Exercise regularly Get routine health screenings Prevention is the best defence against serious diseases