Prevalence of E-Cigarette Use, Perceptions, and Attitudes Among Adolescents in Rural Communities of Samut Songkhram Province, Thailand: A Cross-Sectional Study

Electronic cigarette use among adolescents is an emerging public health concern, yet evidence from specific rural communities in Thailand remains limited. This cross-sectional study estimated the prevalence of e-cigarette use, described perceptions of e-cigarettes and attitudes toward e-cigarette use, and examined factors associated with overall attitude scores among 512 participants recruited from selected rural communities in Samut Songkhram Province, Thailand. The mean age was 18.46 years (SD = 1.37). Data were collected from December 2024 to August 2025 using a structured questionnaire and analyzed using descriptive statistics and multiple linear regression. Current e-cigarette use, defined as use within the previous 30 days, was reported by 5.86% of participants, while 18.36% reported lifetime use. Overall perceptions of e-cigarettes were classified as high (M = 2.52, SD = 0.34), whereas overall attitudes toward e-cigarette use were classified as good (M = 2.73, SD = 0.40). Sex was positively associated with overall attitude scores (B = 0.109, β = 0.097, p = 0.023), whereas perceptions of e-cigarettes were negatively associated with attitude scores (B = −0.473, β = −0.343, p < 0.001). The model explained 12.3% of the variance in overall attitudes. Among adolescents participating in this study from selected rural communities in Samut Songkhram Province, the findings indicate ongoing e-cigarette experimentation and highlight the potential importance of coordinated prevention strategies addressing peer influence, misconceptions, affective attitudes, and access through informal and online channels. These findings should be interpreted within the specific study setting and sampling design and should not be generalized to adolescents in rural Thailand as a whole.