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Participants completed a self-administered electronic questionnaire assessing sociodemographic characteristics, academic performance, age of initiation, exposure to e-cigarette use in the environment (defined as having 1 or more e-cigarette users among family, relatives, or friends), perceived risks, and attitudes toward e-cigarettes (the higher score indicates risky attitudes toward e-cigarettes). The outcome was successful cessation, defined as being a former e-cigarette user (no use in the past 12\u2009months among ever-users). Multiple logistic regression analyses were used to explore the factors associated with successful e-cigarette quitting. The gender subgroup analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 277 participants, 114 (41.2%) were former users and 163 (58.8%) were current users. The absence of e-cigarette users in the environment (aOR 0.38, 95% CI 0.22-0.67,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001) and risky attitudes toward e-cigarettes (aOR 0.79, 95% CI 0.72-0.88,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) were independently associated with cessation. Subgroup analysis confirmed the importance of attitudes for both males and females, while environmental exposure was significant among females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Successful cessation among secondary school students was strongly associated with less risky attitudes toward e-cigarettes and the absence of e-cigarette users in the peer and family environment. Interventions should target both individual attitude and environmental factors to improve quit rates. Therefore, interventions should focus on correcting attitudes regarding the social image, stress relief, and socialization aspects of e-cigarettes, while simultaneously engaging families and peers to create a vape-free environment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261415797","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:48:45Z","timestamp":1769687325000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Attitude and Environmental Factors Associated With Successful E-Cigarette Quitting Among Secondary School Students: A Cross-Sectional Observational Study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8131-6474","authenticated-orcid":false,"given":"Wichuda","family":"Jiraporncharoen","sequence":"first","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9735-2587","authenticated-orcid":false,"given":"Nida","family":"Buawangpong","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasiri","family":"Singhasiri","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Awirut","family":"Oon-arom","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-4582","authenticated-orcid":false,"given":"Wachiranun","family":"Sirikul","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pimploy","family":"Choradon","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2686-3269","authenticated-orcid":false,"given":"Thanachat","family":"Yotruangsri","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apinun","family":"Aramrattana","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanittha","family":"Thaikla","sequence":"additional","affiliation":[{"name":"Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanrawee","family":"Tongton","sequence":"additional","affiliation":[{"name":"Hang Dong Hospital, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atchararapee","family":"Champa","sequence":"additional","affiliation":[{"name":"Hang Dong Hospital, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"World Health Organization. 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