Behavioral-Based Nursing Interventions: Impact on E-Cigarette Dependence , Social Media Usage, and Perceived Stress among High School Students

Document Type : Original Article

Authors

1 Lecturer of Psychiatric and Mental Health Nursing, Faculty of Nursing, Menoufia University, Egypt.

2 Assistant Professor of Psychiatric and Mental Health Nursing, Faculty of Nursing, Menoufia University, Egypt

3 3Assistant professor in Psychiatric and Mental health Nursing, Faculty of Nursing, Menoufia University, Egypt 4Clinical Psychology, Health Sciences Department, Health and Rehabilitation Sciences College, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

10.21608/tsnj.2025.457087

Abstract

Background: Electronic cigarette use, and excessive social media usage have increased exponentially in Egypt and: all over the world. High school students facing simultaneous exposure to e-cigarette use and excessive social media engagement are at elevated risk for perceived stress and many psychological problems. So, this study aimed to evaluate the impact of behavioral-based nursing interventions in reducing e-cigarette dependence, social media usage, and the perceived stress level among high school students. Subjects and method: A quasi-experimental research design was utilized from March 2025 to July 2025. Setting: The study was conducted at the 4 secondary schools in Shebin El-Kom city, Menoufia Governorate, Egypt. Subjects: A purposive sample of 600 students was selected from the previously mentioned setting using stratified random sampling. Tools of data collection: four valid tools were used in data collection: tool 1: A structured interview questionnaire to assess socio demographic characteristics of the studied students, tool 2: electronic Fagerström test for nicotine dependence (eFTND) to assess degree of addiction to e-cigarettes, tool 3: social media usage scale (SMUS) to assess frequency and intensity of platform use, and tool 4: perceived stress scale (PSS) to assess psychological stress. Data was analyzed at two points: pre-intervention and post-intervention. Results showed no statistically significant differences between groups in the amount of e-cigarette dependence, social media usage, and the perceived stress level pre-intervention. But after the intervention, the study group exhibited significant reductions in e-cigarette dependence levels, social media usage, and perceived stress levels. Conclusion: Behavioral-based nursing interventions effectively reduce excessive e-cigarette dependence, social media usage, and perceived stress among high school students. Recommendations: The study recommends adding behavioral training modules to school curricula across the country, including modules on digital well-being, nicotine harm reduction, and managing stress.