Decision to use e-cigarettes and associated factors among students of a university in Northern Thailand

The use of electronic cigarettes (e-cigarettes) is spreading among adolescents, especially at higher education institutions, and it may have effects on health and learning. The objectives of this cross-sectional study were to examine the decision to use e-cigarettes and identify the associated factors among students of a university in northern Thailand.

Data were collected by using a developed questionnaire via an online system with 430 undergraduate students from a university in northern Thailand. Samples were selected by stratified random sampling. Data were analyzed using frequencies and percentages, means and standard deviations, and logistic regression at a confidence level of 0.05.

In a sample group, the decision to use e-cigarettes was found to be 18.6%. Factors significantly associated with the decision to use e-cigarettes included receiving information about the dangers of e-cigarettes from loved ones (AOR=2.84; 95% CI: 1.20-6.71), having friends who use e-cigarettes (AOR=8.53; 95% CI: 3.41-21.37), attitudes toward e-cigarettes (AOR=3.10; 95% CI: 1.61-5.95), perceived risk of e-cigarette use (AOR=2.51; 95% CI: 1.22-5.13), and perceived benefit of avoiding e-cigarette use (AOR=2.38; 95% CI: 1.23-4.57).

The factors associated with the decision to use e-cigarettes were found to be directly related to the students themselves, as well as their friends, acquaintances, and partners. Therefore, universities should have a policy to prevent the use of e-cigarettes by focusing on the individual level with all students. Further, activities should be organized in groups, especially among friends and partners, with a focus on changing attitudes, providing accurate information, and increasing the perceptions of e-cigarette risks as well as the benefits of avoiding e-cigarette use.