Use of Electronic Cigarettes Among High School Students in Sorowako: Prevalence, Safety Perceptions, and Health Education Impact
DOI:
https://doi.org/10.20956/y6nr2813Abstract
Introduction: Adolescent electronic cigarette (e-cigarette) use is increasing worldwide, driven in part by the perception that e-cigarettes are safer than conventional cigarettes. Data on adolescents in Sorowako, a mining town in East Luwu Regency, Indonesia, are lacking. This study aims to assess the prevalence of e-cigarette use, knowledge, and safety perceptions among high school students and to evaluate the short-term impact of a school-based health education session.
Methods: A cross-sectional survey of 601 students from three senior high schools was conducted in November 2025, followed by a one-group pretest–posttest evaluation. Data were collected with a self-administered questionnaire on e-cigarette use, knowledge, and safety perceptions, rated on a five-point Likert scale. Perceptions of users and non-users were compared with the chi-square test. Paired pretest–posttest changes were assessed among 315 students with complete data using the Stuart–Maxwell test of marginal homogeneity and McNemar's test, as appropriate.
Results: Current e-cigarette use was reported by 2.2% of students, while 9.5% reported ever-use. Knowledge gaps were evident: 51.2% were unsure whether e-cigarettes contain only nicotine, 40.3% were unsure whether they contain carcinogenic compounds, and 55.1% were unsure whether they are free of tar and carbon monoxide. Additionally, 30.6% incorrectly believed that e-cigarettes do not contain these combustion-related substances. Overall, 12.8% perceived e-cigarettes as safer than conventional cigarettes, while 30.8% were unsure. This perception was more common among ever-users than non-users (29.3% vs. 8.6%; P < 0.001). Following the intervention, recognition that e-cigarettes contain carcinogenic compounds increased from 52.4% to 68.9% (+16.5 percentage points), while the proportion agreeing that e-cigarettes are safer than conventional cigarettes decreased from 12.4% to 8.9% (−3.5 percentage points). Nevertheless, 43.5% remained unsure whether e-cigarettes are free of tar and carbon monoxide.
Conclusion: Current e-cigarette use among high school students in Sorowako was relatively uncommon, but important misconceptions about e-cigarette composition and safety persisted. Following a single large-group educational session, responses shifted toward greater recognition of several potential risks, although uncertainty remained regarding aerosol composition. Smaller, interactive, and repeated educational sessions warrant further evaluation using controlled study designs and longer follow-up.
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