The internal and external risk factors related to e-cigarette smoking initiation among selected college participants in a higher education institution in the National Capital Region (NCR), Philippines

Due to limited data on the e-cigarette use of tertiary education students in the Philippines, this research examined the internal and external risk factors that may lead to e-cigarette initiation. An online survey questionnaire was administered to 352 individuals, with 95 of them being e-cigarette smokers. Specifically, 36.8% were current users, 12.6% had used them in the past, and 50.5% had tried them at least once. Statistical measurements such as frequency, percent, mean, and mode were used to quantify variables such as socio-demographics. The Patient Health Questionnaire (PHQ-4) was used to measure mental health and stress-induced factors. The Fisher's Exact Test was utilized to identify the significant internal and external risk factors, as well as the perceptions of e-cigarette users. Statistical analysis showed two internal risk factors (i.e., gender, and mental health and stress-induced factors) to be highly significant, and all external risk factors (i.e., family, peers, media) were also highly significant. Perceptions of the harmful effects of e-cigarettes and breathing their vapor have also shown to be highly significant, wherein a lower perception of harm showed a greater and more frequent e-cigarette use. Socio-demographic characteristics such as the father’s educational attainment showed high significance in e-cigarette initiation, wherein students whose fathers have a higher degree of education showed lesser e-cigarette use. The identified risk factors may be beneficial in creating long-term interventions to limit the expansion of e-cigarette initiation in tertiary education institutions and be used to promote awareness of the negative effects of e-cigarettes.