Abstract

Objective:The study explored e-cigarette use among youth and associated factors in Thailand. Methods:This was a cross sectional study of 6,045 seventh grade students selected using a multistage design. Self-administered questionnaires relating to the socio-demographic characteristics, history of cigarette and e-cigarette uses, friends’ and family’s use of e-cigarettes, knowledge and perception of e-cigarette use, history of alcohol uses, and life assets were gathered. Multivariate logistic regression models were used to examine the variables and their association with e-cigarette use. Results:Prevalence of ever e-cigarette use was 7.2% and current e-cigarette use was 3.7%. We found that current cigarette smoking (AOR 4.28, 95% CI: 2.05-8.94), parental e-cigarette use (AOR 6.08, 95% CI: 2.81-13.17), peer e-cigarette use (AOR 3.82, 95% CI: 2.19-6.65), peer approval of smoking (AOR 1.95, 95% CI: 1.11-3.41), and unaware of e-cigarettes’ risk (AOR 5.25, 95% CI: 2.67-10.34). were significantly associated with current use of e-cigarettes. Male sex, poor academic achievement, and poor life assets (power of wisdom) were only significantly associated with ever e-cigarette use. Conclusion:Prevalence of current e-cigarette use among Thai middle school students did not change significantly since the government banned importation and sales of e-cigarettes in 2015, suggesting that the Thai ban has been a success. Factors associated with e-cigarette use among Thai youth were consistent with other countries. Ever e-cigarette use, increased, but less than in countries without a ban. To strengthen efforts to prevent youth from e-cigarette use and addiction, the government should improve law enforcement, especially against online marketing and strengthen school-based anti-smoking programs to include e-cigarette lessons, educating parents and the public about the harm of e-cigarettes, including secondhand effects on non-users.

Highlights

  • Electronic cigarettes (e-cigarettes) were first marketed in China in 2004, became available in Europe in 2006 and the US in 2007 (Henningfield and Zaatari, 2010; Riker et al, 2012)

  • The prevalence of evere-cigarette use among boys was higher than girls (11.2% vs. 2.8%)

  • The continued low prevalence of current e-cigarette use among youth we found in this study could be the effect of the ban because use was not statistically significantly different from the prevalence from the 2015 survey (3.7% in 2019 vs. 3.3% in 2015 (Chotbenjamaporn et al, 2017), p=0.359

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Summary

Introduction

Electronic cigarettes (e-cigarettes) were first marketed in China in 2004, became available in Europe in 2006 and the US in 2007 (Henningfield and Zaatari, 2010; Riker et al, 2012). In less than ten years since e-cigarettes were introduced, e-cigarettes have become the most commonly used tobacco product among youths in many countries (Filippidis et al, 2017; Wang et al, 2018; Brown et al, 2020; Cole et al, 2021). Factors associated with e-cigarette awareness, perception, and use among youth have been studied almost exclusively in high-income countries (HICs) and where sales of e-cigarettes are not banned (Kong et al, 2015; Jiang et al, 2016; Park et al, 2017; Romijnders et al, 2018). Prior research shows that youth e-cigarette use is associated with male sex (Barrington-Trimis et al, 2015; Jiang et al, 2016; Park et al, 2017; Robert Lourdes et al, 2019; Soteriades et al, 2020), residence in urban areas (Park et al, 2017), low academic achievement

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