Saadi M. Saleh, Abdullah Al-Janabi, Moaz Elsayed Abouelmagd, Omar Habib, Siham M. Abdi, Mariam Zainab, Nermeen Ahmed Hassan, Alia Alkhayer, Basma Ahmed Mohammed Al-Sammraei, Basma Taher, Cesar Khouday, Labibah L. Alswelhi, Mansour A. Algazar, Mariam Alkeswani, Muhsin Aboud, Nabaa Alturfi, Rawshan Ameen Nassrullah, Sara Najim, Safia M. Abdi
BACKGROUND: Electronic nicotine delivery systems (ENDS) use is rising among young adults in the Middle East and North Africa (MENA) region. While marketed as safer alternatives to smoking, their impact on eating behaviors and nutritional habits remains unclear. This study aims to examine the relationship between ENDS use, tobacco smoking, and eating behaviors among young adults in MENA. METHODS: A cross-sectional study was conducted from December 2023 to February 2024 with participants aged 18-35 from Egypt, Iraq, Jordan, Syria, and Saudi Arabia. Data were collected using an online survey and using the Adult Eating Behavior Questionnaire (AEBQ-Ar). Multiple linear and multinomial logistic regressions were used to assess associations after adjustment for key confounders. All statistical tests were conducted through Jamovi 2.3.2 for Windows 11. RESULTS: 3350 participants answered our questionnaire. ENDS-only users had a higher BMI and reported higher consumption of meals (AOR: 2.08; 95% CI: 1.72, 2.52; p < 0.001), spicy food (AOR: 1.82; 95% CI: 1.29, 2.57; p < 0.001), coffee (AOR: 5.98; 95% CI: 1.74, 20.56; p = 0.005), and fizzy drinks (AOR: 7.23; 95% CI: 2.06, 25.31; p = 0.002) compared to non-smokers. ENDS-only users showed significant associations with emotional overeating (β: 0.093; 95% CI: 0.001, 0.186; p = 0.048), increased satiety responsiveness (β: 0.179; 95% CI: 0.084, 0.273; p < 0.001), and reduced enjoyment of food (β: -0.364; 95% CI: -0.458, -0.269; p < 0.001). Tobacco smokers were more likely to consume fatty foods (AOR: 1.61; 95% CI: 1.16, 2.24; p = 0.004). Furthermore, tobacco-only smokers, ENDS-only users, and dual-users had higher odds for alcohol consumption compared to non-smokers. CONCLUSION: ENDS users exhibit distinct eating behaviors. These behaviors may have long-term implications for their physical health and psychological well-being. Further studies are needed to confirm our findings.