{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T14:11:04Z","timestamp":1778163064444,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: Electronic cigarettes (e-cigarettes) are an important public health concern, particularly amongst young individuals. This study aimed to assess the attitudes and factors, including mental distress, that influence e-cigarette use amongst university students in Southern Thailand, including in armed conflict areas. Methods: A cross-sectional survey was conducted at the Prince of Songkla University across two campuses: Hat yai and Pattani. Data on demographics, attitudes towards e-cigarettes, usage patterns, and mental health (using the 21-item Depression, Anxiety, and Stress Scale) were collected and analysed using R software. Results: Amongst 901 participants (236 men and 665 women), the prevalence of e-cigarette use was 6.9%. Men (OR = 2.65; 95% CI = [1.28, 5.46]), tobacco users (OR = 97.56; 95% CI = [26.77, 355.66]), and those living alone (OR = 13.48; 95% CI = [1.21, 150.47]) were more likely to engage in e-cigarette use. Additionally, Islamic students reported lower usage rates than their Buddhist counterparts (OR = 0.32; 95% CI = [0.11, 0.9]). Conclusions: E-cigarette users exhibited higher scores on the depression, anxiety, and stress subscales than non-users. Smokers perceived e-cigarettes as a means of reducing tobacco consumption, alleviating stress, and enhancing their image. Moreover, non-smokers believed that e-cigarettes should be \u2018illegal\u2019 in Thailand.<\/jats:p>","DOI":"10.3390\/healthcare14101263","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:15:07Z","timestamp":1778156107000},"page":"1263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Electronic Cigarette Usage and Psychological Distress: Insights from University Students Amidst the Armed Conflict in Southern Thailand"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3390-413X","authenticated-orcid":false,"given":"Tharntip","family":"Sangsuwan","sequence":"first","affiliation":[{"name":"Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9765-2184","authenticated-orcid":false,"given":"Chonnakarn","family":"Jatchavala","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhawarun","family":"Akkaraprasit","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bunyisa","family":"Thaoun","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pariyawit","family":"Suwancharoen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8641-9923","authenticated-orcid":false,"given":"Piyaphat","family":"Udompongpaiboon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natnicha","family":"Ponintawong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nontapat","family":"Lertnukkhid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Passaporn","family":"Chothikasatien","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irfan","family":"Saleh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chen, G., Rahman, S., and Lutfy, K. 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