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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

K. Lim, Y. Cheong, K. K. Lim, Jia H. Lim, K. C. Cheong, Sumarni Mohd Ghazali, A. Marine, Mohd Hazilas Mat Hashim et al.

Tobacco Induced Diseases, 2026

Abstract

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…

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