Utilization of electronic nicotine delivery systems, heated tobacco products among Vietnamese students: a multivariate analysis of knowledge, attitudes, and behaviors

Objective: This study aims to describe the knowledge, attitudes, and behaviors of using electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs), and related factors among high school students in four provinces (including Hanoi, Hai Phong, Quang Ninh, and Can Tho) in the year 2022. Method: A cross-sectional quantitative study with analysis was conducted on 1,043 high school students in the four provinces through questionnaires. Results: Approximately 27% and 81% of the students demonstrated adequate knowledge and positive attitudes towards ENDS, and HTPs, respectively. The prevalence of students who smoked ENDS and/or HTPs in the past month was 4%, with the highest rate observed in Hanoi (roughly 12%). Factors associated with knowledge, attitudes, and smoking behavior included their province/city of residence, exposure to information, gender, academic grade, and having friends who smoke. Conclusion: It is crucial to implement strategies that enhance accurate knowledge among students and strengthen the regulation of the purchase and use of ENDS and HTPs in the market in order to mitigate tobacco use behaviors among adolescents. Keywords: High school students, electronic nicotine delivery systems, electronic cigarettes, heated tobacco products, new generation tobacco products, influencing factors