E-cigarette use among university students in Vietnam following the 2025 e-cigarette ban policy: A multicity...

Electronic cigarette (e-cigarette, EC) use is a growing public health concern among young people worldwide. In Vietnam, Resolution No. 173/2024/QH15 prohibited e-cigarettes and heated tobacco products from January 2025. However, evidence on EC use among university students after implementation of this policy remains limited. This study assessed the prevalence of EC use and associated factors among Vietnamese university students in the post-ban period.

A cross-sectional study was conducted among 2462 students recruited using a multi-stage cluster sampling approach from universities in Hanoi, Hue, Da Nang, and Ho Chi Minh City representing major urban regions, between October and December 2025. Data were collected using a structured self-administered questionnaire. Multivariable logistic regression, adjusted for sociodemographic and social/behavioral covariates, was performed to identify factors associated with e-cigarette use.

The mean age of the study participants was 19.5 years (SD=1.3). The prevalence of ever use (defined as former and current use) and current e-cigarette use was 17.7% and 3.3%, respectively. Female students were less likely than males to report ever use (adjusted odds ratio, AOR=0.70; 95% CI: 0.51-0.96) and current use (AOR=0.30; 95% CI: 0.13-0.72). Ever e-cigarette use was associated with peer use of e-cigarettes or heated tobacco products (AOR=3.17; 95% CI: 2.40-4.19), conventional cigarette smoking (AOR=21.00; 95% CI: 15.74-28.04), and exposure to e-cigarette advertising (AOR=1.36; 95% CI: 1.03-1.79). Current use was associated with family member use (AOR=2.62; 95% CI: 1.17-5.87), peer use (AOR=3.35; 95% CI: 1.92-5.87), conventional cigarette smoking (AOR=14.83; 95% CI: 7.91-27.83), and exposure to e-cigarette advertising (AOR=2.49; 95% CI: 1.47-4.21).

Although current e-cigarette use was lower than levels reported in several pre-ban university studies, use remains. Male students, conventional cigarette smokers, students with peers or family members using ECs or heated tobacco products, and those exposed to advertising were more likely to report use. Continued surveillance and further longitudinal studies are needed to monitor EC use trends and to evaluate the long-term impact of the ban among Vietnamese university students.