Thai youth ecig use stays low since country banned imports and sales

While countries like the USA struggle with exploding e-cig use among youth, in Thailand, which bans the import and sales of e-cigarettes (which under Thai law also includes heated tobacco products), youth use remains stable and low. Roengrudee Patanavanich and colleagues (including me) recently published “Use of E-Cigarettes and Associated Factors among Youth in Thailand” in Asian Pacific Journal of Cancer Prevention that reported the results of a 2019 survey of middle school students that found that 3.7% were current e-cigarette users. This compares with 10.5% among US middle school students the same year.

This is important information to support continuing the ban in the face of ongoing pressure from the multinational tobacco companies and their allies, not only in Thailand but also other countries that continue to protect their citizens from these new tobacco products.

Here is the abstract:

Objective: The study explored e-cigarette use among youth and associated factors in Thailand.

Methods: This was a cross sectional study of 6,045 seventh grade students selected using a multistage design. Self-administered questionnaires relating to the socio-demographic characteristics, history of cigarette and e-cigarette uses, friends’ and family’s use of e-cigarettes, knowledge and perception of e-cigarette use, history of alcohol uses, and life assets were gathered. Multivariate logistic regression models were used to examine the variables and their association with e-cigarette use.

Results: Prevalence of ever e-cigarette use was 7.2% and current e-cigarette use was 3.7%. We found that current cigarette smoking (AOR 4.28, 95% CI: 2.05-8.94), parental e-cigarette use (AOR 6.08, 95% CI: 2.81-13.17), peer e-cigarette use (AOR 3.82, 95% CI: 2.19-6.65), peer approval of smoking (AOR 1.95, 95% CI: 1.11-3.41), and unaware of e-cigarettes’ risk (AOR 5.25, 95% CI: 2.67-10.34). were significantly associated with current use of e-cigarettes. Male sex, poor academic achievement, and poor life assets (power of wisdom) were only significantly associated with ever e-cigarette use.

Conclusion: Prevalence of current e-cigarette use among Thai middle school students did not change significantly since the government banned importation and sales of e-cigarettes in 2015, suggesting that the Thai ban has been a success. Factors associated with e-cigarette use among Thai youth were consistent with other countries. Ever e-cigarette use, increased, but less than in countries without a ban. To strengthen efforts to prevent youth from e-cigarette use and addiction, the government should improve law enforcement, especially against online marketing and strengthen school-based anti-smoking programs to include e-cigarette lessons, educating parents and the public about the harm of e-cigarettes, including secondhand effects on non-users.

The full citation is: Patanavanich R, Aekplakorn W, Glantz SA, Kalayasiri R. Use of E-Cigarettes and Associated Factors among Youth in Thailand. Asian Pac J Cancer Prev. 2021 Jul 1;22(7):2199-2207. doi: 10.31557/APJCP.2021.22.7.2199. PMID: 34319044. It is available here.

Published by Stanton Glantz

Stanton Glantz is a retired Professor of Medicine who served on the University of California San Francisco faculty for 45 years. He conducts research on tobacco and cannabis control and cardiovascular disease/

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