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Prevalence and Factors Influencing E-cigarette Smoking Behavior Among Thai Children and Youth

Abstract

This study aimed to examine the prevalence and influencing factors of E-cigarette smoking behavior among Thai children and youth. A cross-sectional analytical study design was employed using secondary data from the 2024 National Health Behaviors Surveillance Database on E-Cigarette Use in Thailand, compiled by the Bureau of Health Education, Department of Health Service Support. The target population included Thai children and youth aged 10–24 years. The sample size of 7,900 participants was determined using a proportion estimation formula for an unknown population size and selected through simple random sampling based on pre-defined criteria. Descriptive statistics were used, including percentages, means, standard deviations. Multiple logistic regression was used to analyze the influence of independent variables.

The findings showed that 26.14% (95% CI: 0.25, 0.27) of Thai children and youth reported using e-cigarettes. Key factors associated with e-cigarette use included: traditional cigarette smoking (AOR = 4.52; 95% CI: 3.56, 5.73), having a suboptimal attitude (AOR = 3.65; 95% CI: 3.16, 4.22), kratom drink consumption (AOR = 2.96; 95% CI: 2.32, 3.78), alcohol consumption (AOR = 2.40; 95% CI: 2.08, 2.76), stress (AOR = 1.32; 95% CI: 1.15, 1.53), parental marital status (AOR = 1.26; 95% CI: 1.11, 1.44), witnessing celebrities using e-cigarettes (AOR = 1.20; 95% CI: 1.04, 1.36), access to e-cigarette products (AOR = 1.24; 95% CI: 1.07, 1.43), having friends or partners who use e-cigarettes (AOR = 2.71; 95% CI: 2.29, 3.21), and being persuaded to use e-cigarettes (AOR = 1.72; 95% CI: 1.50, 1.98).

Relevant agencies should implement integrated interventions targeting both internal and external risk factors. Priority should be given to at-risk groups, including those who smoke traditional cigarettes, consume kratom or alcohol, have separated parents, demonstrate poor academic performance, or are enrolled in non-formal education programs.