ArticleTobacco induced diseases2026
Prevalence and associated factors of e-cigarette use tendency among adolescents in a rural community, Thailand: A cross-sectional study.
Article in Tobacco induced diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAdolescent electronic cigarette (e-cigarette) use has increased globally despite regulatory bans. In Thailand, e-cigarettes have been prohibited since 2014; however, adolescent tendency toward e-cigarette use remains a concern. This study aimed to determine the prevalence and associated factors of e-cigarette use tendency among secondary school students in Chachoengsao, Thailand.
methodsA descriptive cross-sectional study was conducted during 18-22 January 2025, among 1848 students aged 13-18 years from 19 secondary schools in Chachoengsao. Participants completed an online self-administered questionnaire on demographics, behaviors, social influences, and e-cigarette knowledge. Tendency was defined as self-reported thoughts about using e-cigarettes. Data were analyzed using descriptive statistics and univariate and multivariate logistic regression, with adjusted odds ratios (AORs), 95% confidence intervals (CIs), and p<0.05 indicating significance.
resultsAmong 1848 students, 17.6% (n=326) reported a tendency to use e-cigarettes. Being female (AOR=1.66; 95% CI: 1.20-2.30) and low household monthly income (<5000 compared with 20000-29999 THB; AOR=2.81; 95% CI: 1.26-6.25) were associated with a higher tendency. Cigarette smoking was the strongest predictor (AOR=6.71; 95% CI: 4.59-9.82) and alcohol use was also significant (AOR=1.71; 95% CI: 1.16-2.54). Peer influence, including neutral attitudes (AOR=1.42) and prior encouragement (AOR=1.95), increased the likelihood of tendency. Perceived social acceptance (AOR=1.75) and misconceptions - such as believing secondhand vapor is harmless (AOR=3.68) or that e-cigarettes aid smoking cessation (AOR=1.93) - were independently associated with tendency.
conclusionsNearly one in six students tended toward e-cigarette use despite the national ban. Female gender, low household monthly income (<5000 THB), risk behaviors, peer influence, and misconceptions were significantly associated factors. Further longitudinal studies are warranted to clarify causal relationships and provide stronger evidence for targeted interventions.
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