E-cigarette use and associated factors among adolescents and young adults in northern Thailand: evidence from a population-based household survey

Introduction E-cigarette use is an emerging public health concern among adolescents and young adults, with limited population-based evidence on recent use and correlates in Thailand beyond school-based samples. Our study aimed to examine e-cigarette use and its associated factors among adolescents and young adults aged 15–29 years in Northern Thailand using data from a population-based household survey. Methods We conducted a cross-sectional analysis of data from the 2024 population-based household survey on substance use in Northern Thailand. The analytic sample included 911 adolescents and young adults aged 15–29 years. Past-year e-cigarette use was the primary outcome. Explanatory variables encompassed sociodemographic characteristics, perceived accessibility, online information-seeking, perceived health harms, household stigma, and co-use of other substances. Descriptive statistics summarized prevalence, and logistic regression models estimated crude and adjusted associations, reporting odds ratios (ORs) and 95% confidence intervals (CIs). Statistical significance was defined as p < 0.05. Results Overall, 11.5% of participants reported past-year e-cigarette use. In adjusted analyses, higher perceived accessibility (AOR = 3.18; 95% CI: 1.31, 7.69, p = 0.010), online information-seeking (AOR = 4.22; 95% CI: 2.36, 7.55, p < 0.001), and past-year alcohol use (AOR = 5.88; 95% CI: 2.83, 12.22, p < 0.001) were associated with higher odds of e-cigarette use. In contrast, perceiving e-cigarettes as harmful (AOR = 0.40; 95% CI: 0.23, 0.69, p = 0.001) and anticipating household stigma (AOR = 0.55; 95% CI: 0.32, 0.95, p = 0.031) were associated with lower odds of use. Conclusion E-cigarette use among adolescents and young adults in Northern Thailand remains a public health concern shaped by accessibility, online exposure, alcohol co-use, and risk perceptions, underscoring the need for strengthened youth tobacco control, digital regulation, and integrated prevention.