Association between socioecological factors and electronic cigarette use among Thai youth: an institution-based cross-sectional study.

OBJECTIVES: This study aimed to examine cigarette use distribution, pattern of e-cigarette use and to determine socioecological model (SEM) factors associated with e-cigarette use among Thai youth (aged 15-24). DESIGN: An institution-based cross-sectional study. PARTICIPANTS: The study conducted in five regions: the north, south, central, northeast and Bangkok area of Thailand from May to October 2021. An internet-based, self-administered questionnaire was developed based on the SEM. We enrolled 13 139 students who understood Thai and voluntarily consented to participate in the study. Hierarchical generalised estimating equations identified the related factors to e-cigarette use consistent with the SEM. RESULTS: Of 12 948 respondents (95.5%), 181 were excluded due to a lack of cigarette use status. Of 12 767, the prevalence of cigarette use was 4.3%, e-cigarette use was 3.5% and dual-use was 2.4%. E-cigarettes were a much more favourable choice among female youth than cigarettes. E-cigarette users tended to express more positive beliefs towards e-cigarettes than non-users. Although the use of e-cigarettes is illegal in Thailand, 66% of users obtained e-cigarettes from online markets and 4% from grocery stores. We found that having a girlfriend or boyfriend who uses e-cigarettes increased the odds of e-cigarette use by 3.239 times. Interestingly, higher odds of e-cigarette use were associated with peer use than with sibling use among e-cigarette users. (Adjusted OR 2.786, 95% CI 1.844 to 4.208 and 2.485, 95% CI 1.402 to 4.404, respectively). Exposure to e-cigarette use in school increased the odds of e-cigarette use by four times. CONCLUSION: This institution-based cross-sectional study revealed that youth e-cigarette use is a significant problem. To prevent the increasing rate of e-cigarette use, health literacy about e-cigarette use, including media and information literacy, should be launched across all levels of the school environment to enlist youth to stand against the negative impacts of e-cigarette use among all those of school age.

"Life is Bitter and Sweet": The Lived Experience of Ethnic Minority Elders with Type 2 Diabetes Mellitus in Rural, Thailand.

PURPOSE: The purpose of this study was to describe the lived experience of ethnic minority elders (EME) with type 2 diabetes mellitus (T2DM) to understand an individual's experience, perception, and behaviors connected to T2DM in rural areas where support is limited. METHOD: The hermeneutic phenomenological methodology was used to explore the lived experience of EME with T2DM by using conversational interviews. Twenty EME were interviewed. The data analysis and interpretation followed the thematic analysis by van Manen. RESULTS: Analysis highlighted an overarching theme of "Life is Bitter and Sweet" and three main themes: (1) the struggle of living with diabetes, (2) living with inequalities, and (3) dealing with diabetes that reflects the experiences of EME with T2DM living in underserved areas based on the cultures, beliefs, and spirits. CONCLUSIONS: The finding led to recommendations to strengthen interventions by family members, improve supportive systems and services to improve knowledge, self-management, and maintain physical well-being in order to increase the quality of life for the EME with T2DM.