Factors Associated With Knowledge and Attitudes toward Electronic Cigarettes among Undergraduate Students at a University in Thailand: A Cross-Sectional Study

Abstract Background: Currently, the use of electronic cigarettes (e-cigarettes) is becoming increasingly popular worldwide among young people, including in Thailand. The myth of e-cigarette safety has fueled its growing popularity among Thai undergraduates. Purpose: This study aimed to investigate factors associated with knowledge and attitudes toward e-cigarettes among undergraduate students at a university in Thailand. Methods: This cross-sectional study was conducted between December 2023 and March 2024 among 384 undergraduate students at a university in Thailand. The data on demographics, knowledge, and attitudes toward e-cigarettes were collected using self-administered questionnaires via Google Forms. Descriptive statistics were used to report percentages and frequencies, while binary logistic regression analyses were used to determine associations using STATA 14. Results: Of the 384 respondents, 28.40% were current smokers, and 76.80% had never received knowledge about e-cigarettes. Logistic regression analysis revealed that females had better knowledge about e-cigarettes than males. (OR=2.22; 95%CI: 1.29-3.82; P<0.004). Additionally, a history of receiving knowledge about e-cigarettes (OR=1.92; 95%CI: 1.00-3.62; P<0.049) was associated with better knowledge about e-cigarettes. Importantly, having divorced or separated parents (OR= 3.92; 95% CI: 1.91-8.04; P<0.001) was associated with more attitudes toward e-cigarettes, whereas undergraduate students living in private accommodation (OR= 0.36; 95% CI: 0.19-0.69; P<0.002), living at house (OR= 0.13; 95% CI: 0.04-0.47; P<0.002), and current smokers of e-cigarettes (OR= 0.21; 95% CI: 0.09-0.48; P<0.001) had less attitudes about e-cigarettes. Conclusions: E-cigarette use is widespread among Thai undergraduate students. These findings highlight the need for university health education to correct misconceptions and raise awareness about the risks and legal bans on e-cigarettes. Strengthening enforcement and peer-led interventions may further curb their use among undergraduate students in Thailand.