Perceptions and psychosocial correlates of e-cigarette use among Hong Kong university students: A mixed-methods study.
- 1Department of Sociology, Hong Kong Shue Yan University, Hong Kong SAR, China.
Abstract
Introduction
E-cigarette use among young adults is a concern in Hong Kong, where alternative smoking products have been prohibited since 2022, with public possession banned from 2026. Evidence among undergraduates is limited. This study examined e-cigarette use and associated psychosocial factors among Hong Kong undergraduates.Methods
A sequential explanatory mixed-methods study was conducted at a Hong Kong university. Phase 1 was a cross-sectional survey (n=267) of full-time undergraduates aged ≥18 years, using convenience sampling. Measures, guided by an extended Theory of Planned Behavior framework, included peer influence, acceptability of public use, and perceived surveillance (1-5 scales). Outcomes were ever e-cigarette use during ages 13-19 years and current (past-30-day) use, analyzed by multivariable logistic regression (AOR, 95% CI). Phase 2 comprised 21 interviews, analyzed inductively.Results
Mean age was 20.8 years (SD=2.0); 55.4% were female. Ever use during ages 13-19 years was 12.4% (33/266) and current use 8.6% (23/266); 86.8% of ever e-cigarette users had also smoked. Peer influence was associated with ever use (AOR=3.34; 95% CI: 1.95-5.73; p<0.001) and current use (AOR=3.20; 95% CI: 1.86-5.49; p<0.001); female sex was inversely associated with ever use (AOR=0.25; 95% CI: 0.09-0.65; p=0.005). Current use was also associated with acceptability of public use (AOR=1.97; 95% CI: 1.08-3.61; p=0.028) and inversely with surveillance (AOR=0.63; 95% CI: 0.41-0.97; p=0.034). Stress relief and peer influence were the most reported reasons for use (43.4% each), and friends the most common source (67.9%). Regulatory deterrence did not differ between users and non-users (p=0.683) despite high policy awareness (89.9%). Interviews described initiation through friends, use under stress, and acquisition through friends and cross-border sourcing.Conclusions
Peer influence was most strongly associated with e-cigarette use; perceived legal deterrence was not. Because this cross-sectional design cannot establish temporal order, further studies are needed to determine causality and characterize informal supply channels among university students.
Related
- Psychosocial correlates of cigarette smoking and e-cigarette use among adults in participating United States jurisdictions: analysis of the 2023 BRFSS
- Cross-sectional correlates and indirect associations linking parental warmth to scores on a study-specific gaming-related symptom index in senior-high-school and university students
- Human papillomavirus (HPV) knowledge, vaccination status, and vaccine-related perceptions among university students in Phoenix, Arizona
- Informal and Professional Awareness of Nonsuicidal Self-Injury: Clinical and Functional Correlates Among Arab Female University Students
- Dancing to wellbeing: a three-wave longitudinal mixed-methods study of Rock “n” Roll Dancesport and psychosocial outcomes in Chinese university students
BibTeX
@article{mai2026perceptions,
title = {{Perceptions and psychosocial correlates of e-cigarette use among Hong Kong university students: A mixed-methods study.}},
author = {Zecheng Mai},
journal = {Tobacco induced diseases},
year = {2026},
month = oct,
doi = {10.18332/tid/226575},
url = {https://europepmc.org/article/MED/42924254},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perceptions and psychosocial correlates of e-cigarette use among Hong Kong university students: A mixed-methods study.
AU - Zecheng Mai
PY - 2026
DA - 2026/10/22
JO - Tobacco induced diseases
DO - 10.18332/tid/226575
UR - https://europepmc.org/article/MED/42924254
AB - Introduction E-cigarette use among young adults is a concern in Hong Kong, where alternative smoking products have been prohibited since 2022, with public possession banned from 2026. Evidence among undergraduates is limited. This study examined e-cigarette use and associated psychosocial factors among Hong Kong undergraduates.Methods A sequential explanatory mixed-methods study was conducted at a Hong Kong university. Phase 1 was a cross-sectional survey (n=267) of full-time undergraduates aged ≥18 years, using convenience sampling. Measures, guided by an extended Theory of Planned Behavior framework, included peer influence, acceptability of public use, and perceived surveillance (1-5 scales). Outcomes were ever e-cigarette use during ages 13-19 years and current (past-30-day) use, analyzed by multivariable logistic regression (AOR, 95% CI). Phase 2 comprised 21 interviews, analyzed inductively.Results Mean age was 20.8 years (SD=2.0); 55.4% were female. Ever use during ages 13-19 years was 12.4% (33/266) and current use 8.6% (23/266); 86.8% of ever e-cigarette users had also smoked. Peer influence was associated with ever use (AOR=3.34; 95% CI: 1.95-5.73; p<0.001) and current use (AOR=3.20; 95% CI: 1.86-5.49; p<0.001); female sex was inversely associated with ever use (AOR=0.25; 95% CI: 0.09-0.65; p=0.005). Current use was also associated with acceptability of public use (AOR=1.97; 95% CI: 1.08-3.61; p=0.028) and inversely with surveillance (AOR=0.63; 95% CI: 0.41-0.97; p=0.034). Stress relief and peer influence were the most reported reasons for use (43.4% each), and friends the most common source (67.9%). Regulatory deterrence did not differ between users and non-users (p=0.683) despite high policy awareness (89.9%). Interviews described initiation through friends, use under stress, and acquisition through friends and cross-border sourcing.Conclusions Peer influence was most strongly associated with e-cigarette use; perceived legal deterrence was not. Because this cross-sectional design cannot establish temporal order, further studies are needed to determine causality and characterize informal supply channels among university students.
SN - 2070-7266
SN - 1617-9625
ER -