Determinants of Electronic Cigarette Use in Indonesia: Results from the 2021 Global Adult Tobacco Survey

Abstract Background: Tobacco smoking remains a significant global public health issue, with electronic cigarette (e-cigarette) use surging in both high- and low-income countries. Objective: This study aimed to examine the determinants of e-cigarette use among Indonesian adults. Methods: We analyzed Indonesia’s 2021 Global Adult Tobacco Survey (GATS). We included a total of 4392 adults aged > 15 years selected through a multistage clustered sampling design. To investigate the association between covariates (age, sex, education, occupation, household wealth, place of residence, smoking status, knowledge, and advertisement) and e-cigarette use, we used multiple logistic regression analysis adjusted for the complex survey. Results: The weighted prevalence of e-cigarette use was 5.4%. The use of e-cigarettes was associated with adults aged 25–44 years (adjusted odds ratio AOR = 0.41, 95% confidence interval (CI) = 0.26; 0.63) and 45 years or older (AOR = 0.12, 95% CI = 0.06; 0.23), being in the richest household (AOR = 2.57, 95% CI = 1.27; 5.10), history of quitting smoking (AOR = 7.01, 95% CI = 2.15; 22.8), current smoking status (AOR = 20.49, 95% CI = 5.99; 70.10), perception that e-cigarette causes serious illness (AOR = 0.60, 95% CI = 0.41; 0.88), and exposure to electronic cigarette advertisement from the Internet (AOR = 1.67, 95% CI = 1.09; 2.57). Conclusion: Various factors influence the use of e-cigarettes. There is an urgent need for comprehensive tobacco control and prevention efforts, particularly among those at a higher risk of using e-cigarettes. Social behavior change communications and strict policies on e-cigarette marketing and advertising are the keys to reducing e-cigarette use.