Introduction: The prevalence of e-cigarette use is increasing globally, particularly among young adults which can predispose them to various health risks. This study aimed to determine the prevalence and factors associated with e-cigarette use among diploma students in a vocational college in a state in Malaysia. Methodology: A cross-sectional study using probability proportionate to size sampling was conducted among 700 diploma students at a vocational college in Malaysia.  A validated, self-administered questionnaire was distributed through the online method from April to May 2024. Bivariate analysis was done using Pearson’s chi-square test or Fisher’s exact and simple logistic regression. Multivariable analysis was performed using multiple logistic regression for variables with a p<0.25 in the bivariate analysis. A value of p<0.05 was considered statistically significant, with a 95% confidence interval. Results: The response rate was 87.7% with the prevalence of e-cigarette use was 29.0%. Factors significantly associated with e-cigarette use included male (aOR = 5.2, 95% CI: 2.7-10.1), other races (aOR = 83.1, 95% CI: 2.2-3146.3), perceived e-cigarette aids in quit smoking (aOR = 1.6, 95% CI: 1.2-2.1), perceived e-cigarette does not contain the toxic chemicals found in conventional cigarette (aOR = 1.4, 95% CI: 1.0-2.0), having close friends who use conventional cigarette (aOR = 2.1, 95% CI: 1.0-4.1) or e-cigarette (aOR = 8.0, 95% CI: 2.3-28.1), e-cigarette exposure on television (aOR = 2.1, 95% CI: 1.0-4.2), positive attitude towards e-cigarette (aOR = 1.2, 95% CI: 1.1-1.2), higher willingness to use (aOR = 1.2, 95% CI: 1.0-1.3), and higher intention to use (aOR = 1.4, 95% CI: 1.2-1.5). Conclusion: Factors associated with e-cigarette use among diploma students included being male, other races (Bumiputera Sabah and Sarawak), positive health risks perceptions, peer influence, and exposure to e-cigarettes on television. Targeted interventions addressing these factors may be more effective in changing social norms and reducing e-cigarette use among this population.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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