Factors Associated with E-Cigarette Use among Undergraduate Students in Phetchabun Province, Thailand: A Cross-Sectional Study
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Abstract
Introduction: E-cigarette use among young people is a growing public health concern. Undergraduate students are particularly vulnerable to initiation, yet evidence on the individual and interpersonal factors associated with use in provincial Thai contexts remains limited. The study aimed to determine the prevalence and identify individual- and interpersonal-level factors associated with e-cigarette use among undergraduate students in Phetchabun Province, informed by the socio-ecological model.
Methods: A cross-sectional survey was conducted among 548 undergraduate students from five higher education institutions in Phetchabun Province, selected using stratified random sampling with proportional allocation by institution. Data were collected between October 2025 and March 2026 via an online questionnaire and analyzed using descriptive statistics, Chi-square tests, and binary logistic regression.
Results: Of 548 participants, most were female (60.95%) and first-year students (38.14%). The 30-day prevalence of e-cigarette use was 9.85%. Binary logistic regression identified four factors significantly associated with use (p-value < 0.050): positive attitude toward e-cigarettes (AOR = 11.40 and 5.04 for moderate and high attitude, respectively), low perception of related laws (AOR = 3.83), low and moderate self-efficacy (AOR = 5.03 and 4.04, respectively), and influence from close persons, for which the absence of such influence was protective (AOR = 0.016). Several estimates, including this last one, had wide confidence intervals and should be interpreted with caution.
Conclusion: These findings suggest that e-cigarette use among undergraduate students is associated with individual- and interpersonal-level factors, including attitude, legal awareness, self-efficacy, and peer influence. Prevention strategies addressing these factors may be worth considering, although the cross-sectional design limits causal inference and generalizability beyond this setting.
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