Using an ecological model of health behaviour to identify factors associated with smoking behaviour among Buddhist novices in Thailand: a cross-sectional digital survey.

OBJECTIVE: Buddhist novices reside in Buddhist temples, which are legally designated as smoke-free areas. Nevertheless, similar to other men in their age group, they are susceptible to various risk factors that lead to smoking. This digital survey aimed to examine tobacco smoking and its associated factors among Buddhist novices in Thailand. DESIGN: A cross-sectional digital survey. SETTING: 88 temple-based schools in Thailand. PARTICIPANTS: A stratified two-stage cluster sampling method was employed to select 5371 novices. Data were collected between June and August 2022 using self-administered electronic questionnaires. MEASURE: Descriptive statistics and multivariable logistic regression analysis were used to identify the associated factors. RESULTS: Overall, 32.8% of the respondents reported they had tried smoking, and the average age of initiation was 12.4 years. In the past 30 days, 25.7% had smoked any tobacco product. Multiple factors following the ecological model of health behaviour were found to be statistically associated with smoking by 37.3%. Among these were intrapersonal-level factors, such as age, living in the southern region and attempted smoking. Two were interpersonal-level factors: the smoking behaviour of close relatives, specifically parents, and their respected monks. Two were institutional-level factors: perceiving that temple-based schools are smoke-free areas and exposure to secondhand smoke. Three factors at the community and policy levels were noticed tobacco advertising at the point of sale, social media and tobacco promotion. CONCLUSION: The findings of this study support the development of comprehensive intervention programmes that address the multiple factors to prevent Buddhist novices from smoking.

Factors associated with e-cigarette use among vocational students: A cross-sectional multistage cluster survey, Thailand.

INTRODUCTION: The use of e-cigarettes has steadily increased, and vocational students are one primary target of e-cigarette marketing. This cross-sectional survey research aimed to explore e-cigarette use and examine the factors associated with it. METHODS: Multistage cluster random sampling was employed to select 1536 students in vocational education institutions. A self-administered questionnaire was used to collect the data from September to December 2019. Multinomial logistic regression analysis was used to obtain the adjusted odds ratio (AOR) to determine the associated factors of e-cigarette use. RESULTS: Altogether, 28.7% of the subjects were currently e-cigarette users, 7.4% used e-cigarettes only, and 21.3% were dual users. Various factors were found to be significantly associated with e-cigarette use by 43.7%. Those consisted of sex (male) (AOR=2.183; 95% CI: 1.510-3.157), grade point average (GPA) of <2.5 (AOR=2.363; 95% CI: 1.502-3.717), having neutral attitudes toward e-cigarette use (AOR=2.676; 95% CI: 1.499-4.779) and positive attitudes toward e-cigarette use (AOR=4.171; 95% CI: 2.250-7.734), moderate level of perceived behavioral control on e-cigarette use (AOR=3.520; 95% CI: 2.287-5.418) and low level of perceived behavioral control on e-cigarettes use (AOR=4.959; 95% CI: 3.274-7.511), moderate price of e-cigarettes (AOR=1.436; 95% CI: 1.009-2.044), and e-cigarette use of their parents (AOR=1.827; 95% CI: 1.137-2.938), close friends (AOR=4.327; 95% CI: 2.954-6.338) and idols (AOR=4.604; 95% CI: 1.844-11.497). CONCLUSIONS: Students should be encouraged to develop negative attitudes toward e-cigarette use and increase their self-confidence to control the use of e-cigarettes. This can be achieved by regularly distributing information on the product's risks. Moreover, students can find inspiration and guidance from peers, close friends, or their idols, who will act as positive role models and inspire them not to initiate e-cigarette use.

Use of e-cigarettes among public health students in Thailand: Embedded mixed-methods design.

INTRODUCTION: E-cigarettes are new tobacco products widely used among adolescents. Public health students are not only susceptible to e-cigarette use, but they should also serve as non-smoking role models. The study aimed to investigate the current situation of e-cigarette use and the factors associated with its use among public health students. METHODS: In this embedded mixed-methods design, the primary approach was a cross-sectional online survey. The samples were 2302 third-year public health students from 37 public health education institutes across Thailand. Stratified two-stage cluster random sampling was employed to select the subjects. Data were collected using self-administered questionnaires from January to March 2021. A checklist form was employed to collect qualitative data about teaching and learning activities related to tobacco control in June 2021. Descriptive statistics were used for data analysis, including inferential statistics regarding logistic regression. RESULTS: Overall, 3.9% (95% CI: 3.1-4.6) of the students currently used e-cigarettes in the past 30 days. The significant factors that could explain 43.4% of e-cigarette use were predisposing factors: being male (adjusted odds ratio, AOR=1.8; 95% CI: 1.0-3.3), having a neutral attitude toward e-cigarette use (AOR=2.2; 95% CI: 1.1-4.5), and not believing that public health professionals should serve as non-smoking role models for clients and the general public (AOR=2.3; 95% CI: 1.2-4.0). The enabling factor was having tried tobacco products (AOR=40.7; 95% CI: 19.1-87.1), and the reinforcing factor was having three or more close friends who smoke cigarettes (AOR=3.2; 95% CI: 1.8-5.8). CONCLUSIONS: Students' behaviors should be modified through curriculum-based teaching and learning activities to develop negative attitudes toward e-cigarette smoking, increase students' awareness as non-smoking role models, and establish smoke-free environments.