Trends in e-cigarette use among populations in urban areas

Abstract

Over the past decade, e-cigarette use has increased rapidly and has become an important global public health concern, particularly among youth. Thailand is currently facing a "new epidemic" with a continuous rise in prevalence within urban areas despite strict legal measures. The objective of this study is to analyze the situation and trends of e-cigarette use among populations in urban areas from 2015 to 2025 and identify associated factors, with a specific focus on youth. Employing a descriptive research design and retrospective trend analysis of secondary data from international and national health organizations, such as the WHO and the Tobacco Control Research and Knowledge Management Center, the findings reveal a significant surge in global e-cigarette users from 40 million in 2015 to over 100 million by 2025, with the highest prevalence in Europe and the Americas. Thailand is currently facing a "new epidemic" where prevalence has risen from 3.0% to 10.0–15.0%, totaling approximately 1.7 million users by 2025. Notably, the usage rate among youth aged 13-15 reached 17.6% in 2022, and students exhibited a usage rate as high as 22.65%. Regarding associated factors, the study indicates that males are 3 times more likely to use e-cigarettes than females. Significant correlations were found with risk clustering behaviors traditional smokers are 5 times more likely to use e-cigarettes, and alcohol consumers are 3-4 times more likely. Key drivers include social media marketing, sweet-flavored products, and the misconception that e-cigarettes are safer than traditional tobacco, leading to severe health impacts such as EVALI. Policy recommendations focus on managing the "health behavior ecosystem" by strictly regulating online sales, developing real-time proactive urban surveillance systems enhancing health literacy and critical awareness" among youth to address long-term nicotine addiction risks