Comparing mental health and sexual function in dual users of E-cigarettes and conventional cigarettes in Malaysia

Cigarette smoking is associated with adverse mental and sexual health outcomes, yet the effects of dual use of electronic and conventional cigarettes remain unclear, particularly in Southeast Asian populations. This study examined the association between dual nicotine use, mental health, and sexual functioning among Malaysian adults. In this cross-sectional study, 132 participants completed validated measures of nicotine dependence, depression, anxiety, stress, and sexual function. Convenience sampling was used due to the exploratory nature of the study and the difficulty of identifying dual users through probability-based sampling. This study was conducted within a multi-ethnic Malaysian context, allowing examination of substance use behavior within culturally diverse populations. Dual users demonstrated significantly higher sexual desire scores compared with cigarette-only smokers, while no significant differences were observed in psychological outcomes. These findings provide preliminary evidence that dual nicotine use may be associated with variations in sexual desire, although clinical significance remains uncertain. Further longitudinal and mechanistic studies are required to clarify neurobiological and sociocultural pathways linking nicotine exposure with psychological and sexual health outcomes.