The Deputy Director of CRTC reveals that e-cigarettes are aggressively targeting youth, with business operators adjusting their strategies to recruit new smokers through discounts, giveaways, free samples, online sales, and image-building that portrays vaping as safe — compounded by findings that children are 2.5 times more likely to smoke if their parents do, while 46% of children still have a low awareness of the dangers of e-cigarettes.
Today (26 August), Professor Emeritus Dr. Suwanna Ruangkanchanasetr, Deputy Director of the Center for Research and Knowledge Management for Tobacco Control (CRTC), spoke at the Youth @Risk @Change panel discussion at the 24th National Health Academic Conference, addressing the situation of children in Thailand aged 13–15 years, whose smoking rates have risen sharply. Health surveys of the Thai population conducted through physical examinations dating back to 2004 found that the trend of tobacco use has declined across all age groups except among those aged 15–19.
Prof. Emeritus Dr. Suwanna also noted that since e-cigarettes entered Thailand illegally in 2014, over the past 10 years — that is, by 2024 — as many as 420,000 people in the 15–29 age group have been found to use e-cigarettes. She analysed that this is because Thailand has lost the battle against modern 4P marketing, which outperforms campaigns and prevention efforts. The four Ps are as follows: 1. Product — to survive, the tobacco industry has transformed its products into e-cigarettes, which are more portable, and has shifted its target to "new smokers" to replace the declining number of existing smokers. In particular, psychological strategies are used to attract women by linking vaping to an image of equality and capability: "If men can do it, women can do it too — I am a capable woman."
2. Price — there are currently discounts, exchanges, giveaways, gold prize draws, and buy-now-pay-later schemes. 3. Place — everywhere. Previously, sales were very much on-site, but following crackdowns, the method has changed — on-site purchases are not openly available at normal times, but e-cigarettes are concealed in libraries, in places where children gather, and in sports stadiums, sold covertly before the market shifted to online channels. Currently, 80–90% of e-cigarette purchases take place online. 4. Promote — creating deceptive narratives that e-cigarettes are safe, that they are merely water vapour, that they smell good and look cool, and normalising what is abnormal.
Prof. Emeritus Dr. Suwanna further explained the factors influencing e-cigarette use, starting with individual-level factors: 46% of children have a low level of awareness of the dangers of e-cigarettes.
"We found that secondary school students are at greater risk than adults, and in particular, lower secondary students are 15 times more at risk than upper secondary students. They fall for marketing narratives — that it smells nice, looks cool, is not dangerous, or is less dangerous than cigarettes, that it helps quit cigarettes, that it signals good taste and being modern, and that they must smoke to follow their friends."
On the issue of stress, which drives children to seek an outlet, the Deputy Director of CRTC observed that e-cigarettes may temporarily relieve stress, leading children to turn to them. Furthermore, children who use social media were found to vape more than those who do not — and this is precisely where the tobacco industry has been targeting children and youth.
In addition, Prof. Emeritus Dr. Suwanna analysed that when children and youth enter adolescence between the ages of 12 and 15, the brain's reward system — in particular the Nucleus Accumbens, the Ventral Striatum, and the Dopamine Circuit — becomes more active, while the Prefrontal Cortex is not yet fully developed. Children therefore experience stronger urges to try things but have less self-control, making them more inclined to take risks, experiment, and imitate their peers. This is why adolescents use e-cigarettes. Children learn faster than adults, and therefore become addicted faster than adults. Furthermore, the toxic substances in e-cigarettes damage the brain, impairing learning functions, control, and emotional regulation. The next factor is at the community and societal level — for example, laws are not strict enough, 58% of children are exposed to e-cigarette advertising online and are 1.6 times more likely to try e-cigarettes, and children can access or order e-cigarettes easily — 66.7% through the internet and 14% from local community vendors — because there are shops near their homes, or they obtain them from friends.
"The more tobacco shops there are, the more young people become addicted to smoking. What is alarming is that Thailand has 480,000 tobacco retailers, more than the United States, which has 380,000, while ASEAN countries such as Singapore have only 4,000. The next factor is the lack of strict laws."
She also noted that family factors are significant — if someone at home smokes, or if the father smokes, the child will take that as a role model. Looking even deeper, family breakdown — such as single-parent households, a lack of warmth in relationships, and low supervision by family members — also plays a role. We found that students whose guardians use e-cigarettes are 2.5 times more likely to use e-cigarettes themselves, while students who receive regular supervision are 20% less likely to try e-cigarettes.
