Smoking Initiation, Social Exposure and Readiness to Quit among University Students in Durrës, Albania: A Cross-Sectional Study

Abstract

Tobacco use continues to be a significant preventable cause of morbidity and mortality, and experimentation develops in a variety of ways, progressing to habitual use before or in early adulthood. University settings represent a valuable opportunity to identify modifiable smoking-related behaviours. To evaluate smoking initiation, contemporary smoking behaviour, social exposure, smoke-free norms and desire to quit among university students at Aleksandër Moisiu University of Durrës, Albania. Methods: A cross-sectional survey using convenience sampling was conducted from January to April 2026 among 252 university students at Aleksandër Moisiu University of Durrës. The anonymous questionnaire collected data on smoking behaviour, social exposure, smoke-free rules, cessation indicators and demographics. The mean age of participants was 21.3 ± 2.6 years, and 166 students were female (65.9%). Faculty affiliation was distributed across Business (29.4%), Education (21.4%), Information Technology (19.0%), Political Sciences and Law (15.9%) and Professional Studies (14.3%). Among valid responses, 75 students (32.8%) reported smoking during the previous year. First cigarette experimentation was most frequently reported at 18–20 years (29.0%) and 15–17 years (25.3%), while 28.6% had never tried cigarettes. First smoking commonly occurred at home (54.4%) and with friends or colleagues (48.3%). Most students reported an outdoor-only household smoking rule (92.6%). Although 78.6% had considered quitting, only 7.5% reported a known planned quit date. In exploratory adjusted analysis, early initiation (aOR=3.38, 95% CI: 1.80–6.35), having at least half of friends who smoked or used tobacco (aOR=1.92, 95% CI: 1.02–3.60), and male sex (aOR=2.92, 95% CI: 1.54–5.53) were associated with smoking during the previous year, while an outdoor-only household smoking rule showed a borderline inverse association (aOR=0.34, 95% CI: 0.11–1.01). Smoking among UAMD students seems associated with early experimentation, peer settings and household norms, hence, supporting campus-based prevention, smoke-free reinforcement and structured quit-planning treatments.