BACKGROUND: In the aftermath of the COVID-19 pandemic and the reinstatement of regular educational activities, youth worldwide, including those in Bangkok, Thailand, are facing a new public health challenge: the escalating e-cigarette epidemic. This study aimed to identify the prevalence and associated factors based on the PRECEDE model for e-cigarette use among secondary school students in Bangkok, Thailand.
METHODS: A cross-sectional analytic study was conducted in a targeted school offering instruction for all secondary grades (grades 7 – 12) under the Smoke-Free Family Program. The sample was systematically collected from the entire student population attending school on the day of data collection, meeting inclusion criteria, resulting in 2,506 participants. Data were collected through self-administered online questionnaires from August to September 2023. The instruments used were validated and reliable, meeting accepted standards. Multiple logistic regression with adjusted odds ratio (AOR) was employed to investigate significant factors associated with e-cigarette use.
RESULTS: 21.6% (95%CI: 20.0%, 23.2%) of the students had first tried e-cigarettes. Among these, 6 in 10 were regular e-cigarette users within the past 30 days. 20.8% (95%CI: 19.2%, 22.3%) are currently e-cigarette users. Regular e-cigarette use is significantly associated with factors derived from the PRECEDE model, with a 30.0% increase in risk. These factors included a GPA of less than 2.5, insufficient health literacy regarding the dangers and effects of e-cigarettes and other smoked tobacco products, positive attitudes towards e-cigarettes and other smoked tobacco products, and having close contacts who smoke, including siblings/relatives and close friends.
CONCLUSIONS: The findings highlight the need for comprehensive school-based intervention programs that address multiple factors contributing to student e-cigarette use, directly targeting prevention and reduction efforts.