Prevalence and factors associated with intention to use e-cigarettes among lower secondary school students in...

E- cigarettes among youth represent a global public health challenge. The rising prevalence of e-cigarette use among students is a significant public health issue in Thailand. Therefore, this study aimed to identify the factors associated with the intention to smoke e-cigarettes among lower secondary school students in the Bangkok metropolitan area, using the Theory of Planned Behavior (TPB).

A cross-sectional study was conducted among 300 students selected via two-stage cluster random sampling. Data were collected via a questionnaire between May and July 2024. Data analysis included descriptive statistics, chi-squared tests, and independent t-tests for bivariate analysis. Multivariable factors associated with intention were identified using binary logistic regression.

In all, 90.7% of students had a low level of intention to use e-cigarettes. In the bivariate analysis, gender was significantly associated with the intention to use e-cigarettes (p=0.026). The binary logistic regression model, which adjusted for gender and all three TPB constructs, revealed that attitude towards e-cigarette prevention was the only significant factor associated with the intention to use e-cigarettes. Students with a positive attitude toward prevention were 3.82 times more likely to report a low intention to use e-cigarettes (AOR=3.82; 95% CI: 1.40-10.39).

Attitude toward e-cigarette prevention is the primary factor associated with the intention to use e-cigarettes among lower secondary students. These findings suggest that focusing on a positive attitude and refusal self-efficacy, through school and community collaboration, may effectively support prevention efforts.