Sources of electronic cigarette acquisition among school-going adolescents: A cross-sectional analysis of the 2022 National Health and Morbidity Survey - Adolescent Health Survey, Malaysia.

INTRODUCTION

The prevalence of youth e-cigarette use has risen markedly, while traditional cigarette smoking rates have declined in recent years. Restricting access to electronic cigarettes (ECs) is regarded as a potential strategy to reduce their use among adolescents. However, there is a paucity of data on the methods by which Malaysian adolescents acquire e-cigarettes. This study seeks to identify the sources through which secondary school students in Malaysia obtain EC.

METHODS

Data from the 2022 National Health and Morbidity Survey - Adolescent Health Survey, Malaysia, were analyzed. The survey employed a cross-sectional design and multi-stage sampling to obtain a representative sample of secondary school-going adolescents in Malaysia. The analysis included 4609 students who reported e-cigarette use in the past 30 days. Factors related to access and acquisition locations were examined using multivariable logistic regression and chi-squared tests.

RESULTS

Among electronic cigarette (EC) users, 60.4% obtained ECs from commercial sources. Nearly 40% (39.6%) reported acquiring e-cigarettes from friends, while 36.8% purchased them from vape shops. Older age (16-17 years) (AOR=1.52; 95% CI: 1.08-2.14), male gender (AOR=1.72; 95% CI: 1.19-2.49), frequent smoking behavior (AOR=2.49; 95% CI: 1.76-3.52), and having parents who use e-cigarettes (AOR=1.71; 95% CI: 1.29-2.26) were associated with a higher likelihood of obtaining e-cigarettes from commercial sources.

CONCLUSIONS

Peer-to-peer sharing was identified as the most prevalent method of e-cigarette acquisition, although a significant proportion of adolescents also purchased these products from commercial outlets. Continued research is necessary to monitor adolescent access to e-cigarettes. Interventions aimed at reducing adolescent e-cigarette use will be more effective if they address the specific sources from which these products are obtained.