Multiple Tobacco Product Use and Perceived Cognitive Function Among Young Adults in Kuwait: A Cross-Sectional Study

Polytobacco use is a rapidly emerging global public health threat. Epidemiological data regarding the effect of polytobacco use on cognitive function is scarce. Thus, this study aimed to assess the association between polytobacco use and perceived cognitive functioning (PCF) difficulties among young adults.

A cross-sectional study enrolled university students (aged 18-30 years) in Kuwait. Participants self-reported current (past 30-day) use of e-cigarettes, conventional cigarettes, hookah, and heated tobacco products. PCF difficulties were assessed using a validated scale and categorized in 2 ways: (i) as a binary variable ('within normal limits' vs 'mild-to-severe' difficulties) and (ii) as an ordinal variable ('within normal limits,' 'mild,' 'moderate,' or 'severe' difficulties). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models.

Data from 1323 participants were analyzed (805 female participants). Current use of e-cigarettes, conventional cigarettes, hookah, heated tobacco, and ≥3 tobacco products were reported by 333 (25.2%), 294 (22.2%), 183 (13.8%), 158 (11.9%), and 189 (14.3%) participants, respectively. Mild, moderate, and severe PCF difficulties were reported by 208 (15.7%), 165 (12.5%), and 90 (6.8%) participants, respectively, with 463 (35.0%) participants collectively reporting 'mild-to-severe' PCF difficulties. Current use of e-cigarettes (aOR: 1.72, 95% CI: 1.22-2.43), conventional cigarettes (aOR: 1.56, 95% CI: 1.08-2.26), heated tobacco (aOR: 1.49, 95% CI: 1.00-2.21), and ≥3 tobacco products (aOR: 1.96, 95% CI: 1.30-2.97) were associated with increased odds of reporting 'mild-to-severe' PCF difficulties. Moreover, current use of ≥3 tobacco products was associated with increased odds of 'moderate' (aOR: 2.01, 95% CI: 1.14-3.54) and 'severe' (aOR: 3.29, 95% CI: 1.49-7.26) PCF difficulties.

Polytobacco use is common among young adults in Kuwait. This analysis demonstrated an association between current tobacco product use, particularly polytobacco use, and increased odds of experiencing perceived cognitive difficulties.