PREVALENCE AND FACTORS ASSOCIATED WITH ELECTRONIC CIGARETTE USE AMONG SECONDARY SCHOOL STUDENTS IN PHAYAO PROVINCE, THAILAND

Abstract

Electronic cigarette (e-cigarette) use among adolescents is increasing in Thailand despite a legal prohibition on sales and importation. Data on prevalence and associated factors among secondary school students in Phayao Province are lacking. A cross-sectional survey was conducted among 528 students in Grades 7-12 (Mathayom 1-6) from schools in Phayao Province during the 2024 academic year, selected through multistage random sampling. Data were collected using a validated online questionnaire and analyzed with chi-square tests, independent t-tests, and logistic regression. The prevalence of e-cigarette use was 21.97% (116/528). Four factors were independently associated with e-cigarette use: below-average academic performance (Adjusted OR = 3.69, 95% CI: 1.42-9.53), having close friends who use e-cigarettes (Adjusted OR = 3.11, 95% CI: 1.87-5.19), alcohol consumption more than five times per month (Adjusted OR = 2.63, 95% CI: 1.08-6.42), and lack of awareness of e-cigarette control laws (Adjusted OR = 2.27, 95% CI: 1.34-3.86). The design and attractiveness of e-cigarettes, as well as exposure to related media, may also play a role in use behavior, though these factors did not reach statistical significance. E-cigarette use among secondary school students in Phayao Province is common, and peer influence, academic performance, alcohol use, and legal awareness are the strongest associated factors. Health promotion programs should target these high-risk groups, and enforcement of existing e-cigarette control laws should be strengthened.