Exposure to electronic cigarettes and heated tobacco products’ preventive and promotional messages among schoolchildren aged 13–15 in Vietnam: a national cross-sectional study using GYTS 2022 data

BACKGROUND: 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 13-15. METHOD: 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. RESULTS: 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 (≥US0. 9 per week, OR=1. 37, 95% CI 1. 07 to 1. 75; ≥US2. 2 per week, OR=1. 51, 95% CI 1. 16 to 1. 95), parental smoking (OR=2. 50, 95% CI 1. 31 to 4. 78) and current e-cigarette/HTPs user (OR=2. 58, 95% CI 1. 56 to 4. 30) were associated with increased exposure to promotions. Seeing promotions (social media platform: OR=2. 9, 95% CI 1. 7 to 5; websites: OR=3. 4, 95% CI 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% CI 0. 4 to 1. 5). CONCLUSION: 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.