{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:35:28Z","timestamp":1790199328742,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Vietnam Tobacco Control Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The increasing use of electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) among adolescents globally poses significant health risks fuelled by promotional and limited regulations. This cross-sectional study examines the prevalence of e-cigarette and HTP promotions and preventive messages and identifies factors linked to exposure and e-cigarette\/HTP use among Vietnamese schoolchildren aged 13\u201315.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Using data from the 2022 Global Youth Tobacco Survey in Vietnam, 3873 secondary and high school students were analysed. Logistic regression was applied to assess the relationships among demographic factors, exposure to promotional, harm-preventive messages and e-cigarette\/HTP use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results revealed that only 18.3% of the students reported exposure to e-cigarette and HTP promotion messages. However, among those exposed, the majority (10.9% of the total sample) encountered these promotions primarily on social media. In comparison, 66.9% of students encountered preventive messages, mostly via television or radio (28.8% of the total sample). Higher pocket money (\u2265US$0.9 per week, OR=1.37, 95%\u2009CI 1.07 to 1.75; \u2265US$2.2 per week, OR=1.51, 95%\u2009CI 1.16 to 1.95), parental smoking (OR=2.50, 95%\u2009CI 1.31 to 4.78) and current e-cigarette\/HTPs user (OR=2.58, 95%\u2009CI 1.56 to 4.30) were associated with increased exposure to promotions. Seeing promotions (social media platform: OR=2.9, 95%\u2009CI 1.7 to 5; websites: OR=3.4, 95%\u2009CI 1.4 to 8.3) significantly heightened the likelihood of using e-cigarettes and HTPs. In contrast, exposure to preventive messages does not have significant protective effects on e-cigarette\/HTP use (social media platform: OR=0.8, 95%\u2009CI 0.4 to 1.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study highlights a critical gap in tobacco control. While digital promotional communication significantly drives the current use of e-cigarettes\/HTPs among students, current preventive communication does not show a significant protective effect. Public health strategies must urgently prioritise targeting social media and internet platforms to counteract the pervasive influence of the tobacco industry on school-aged children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108400","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:30:37Z","timestamp":1777386637000},"page":"e108400","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Exposure to electronic cigarettes and heated tobacco products\u2019 preventive and promotional messages among schoolchildren aged 13\u201315 in Vietnam: a national cross-sectional study using GYTS 2022 data"],"prefix":"10.1136","volume":"16","author":[{"given":"Bich Diep","family":"Pham","sequence":"first","affiliation":[{"name":"School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6815-9164","authenticated-orcid":false,"given":"Duc Minh","family":"Do","sequence":"additional","affiliation":[{"name":"School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh Ngoc","family":"Luu","sequence":"additional","affiliation":[{"name":"School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi Diem Huong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi Hai","family":"Phan","sequence":"additional","affiliation":[{"name":"Government of Viet Nam Ministry of Health, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu Anh","family":"Duong","sequence":"additional","affiliation":[{"name":"Government of Viet Nam Ministry of Health, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2290-0205","authenticated-orcid":false,"given":"Giang Bao","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026042807300930000_16.4.e108400.1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20196808","article-title":"Electronic Cigarette Harms: Aggregate Evidence Shows Damage to Biological Systems","volume":"20","author":"Hamann","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2026042807300930000_16.4.e108400.2","doi-asserted-by":"crossref","first-page":"105392","DOI":"10.1016\/j.neubiorev.2023.105392","article-title":"The prospective association between the use of E-cigarettes and other psychoactive substances in young people: A systematic review and meta-analysis","volume":"153","author":"Lau","year":"2023","journal-title":"Neurosci Biobehav Rev"},{"key":"2026042807300930000_16.4.e108400.3","doi-asserted-by":"publisher","DOI":"10.1111\/add.16199"},{"key":"2026042807300930000_16.4.e108400.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12954-021-00556-7","article-title":"Estimation of the global number of e-cigarette users in 2020","volume":"18","author":"Jerzy\u0144ski","year":"2021","journal-title":"Harm Reduct J"},{"key":"2026042807300930000_16.4.e108400.5","doi-asserted-by":"publisher","DOI":"10.1108\/DHS-07-2022-0028"},{"key":"2026042807300930000_16.4.e108400.6","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.54872","article-title":"Trends in Current Electronic Cigarette Use Among Youths by Age, Sex, and Race and Ethnicity","volume":"7","author":"Mattingly","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026042807300930000_16.4.e108400.7","unstructured":"Department of Health, World Health Organization, US Centers for Disease Control and Prevention . 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