Knowledge, attitudes, behaviors and some factors affecting the behaviors of using electronic cigarettes among students in four high schools in Viet Tri city, Phu Tho province, 2024

Objective: This study aimed to investigate the knowledge, attitudes, behaviors, and factors influencing e-cigarette use among high school students in Viet Tri City, Phu Tho Province, Vietnam, in 2024. Methods: A cross-sectional study was conducted using a mixed-methods approach, combining a quantitative survey with qualitative interviews. A total of 1,002 students from four high schools participated in the survey. Additionally, eight in-depth interviews were conducted with school administrators and Youth Union representatives, along with two focus group discussions with students. Multivariate logistic regression analysis was employed using the enter method to identify factors associated with e-cigarette use. Results: Among the surveyed students, 57.1% demonstrated satisfactory knowledge, and 76.5% of students had appropriate attitudes towards e-cigarettes. The prevalence of students currently using e-cigarettes was 2.5%, with higher usage rates observed among males (3.6%) compared to females (1.6%). The percentage of students who have ever used e-cigarettes was 5.7% (6.6% for males and 5.0% for females). Multivariate analysis revealed that students with peers who used e-cigarettes, had a history of using traditional cigarettes, drink alcohol, ans had exposure to cigarette advertising were 2.2, 2.1, and 2.7 times more likely to use e-cigarettes than other groups, respectively (p<0.05). Conversely, students with a positive attitude toward resisting e-cigarette use were less likely to engage in this behavior (OR=0.4) (p<0.05). Conclusions: Knowledge and attitudes of students toward e-cigarette use was still limited and a concerning proportion have experimented with or currently use e-cigarettes. Schools play a pivotal role in strengthening educational interventions to correct misconceptions, enhance awareness, and equip students with the necessary skills to resist peer pressure and marketing influences associated with e-cigarette use.