Abstract
The issues of drug addiction are multifaceted and stem from various factors. However, there is still limited epidemiological data regarding vocational students. Therefore, this study aimed to: 1) investigate the prevalence of substance use behaviors and their associated factors among vocational students in the eastern region, and 2) explain the experiences, patterns of substance use behaviors, and relevant factors among vocational students in the eastern region. A mixed methods approach with a convergent design was employed. Quantitative data were gathered from 1,538 vocational students in the eastern region using multistage cluster sampling and then analyzed using chi-square tests, t-tests, and binary logistic regression analysis. Additionally, qualitative data were obtained from 24 individuals through semistructured interviews and analyzed using thematic analysis. The research findings reveal that a majority of the sample group were males, with an average age of 17.87 years (SD = 1.47) and an average monthly income ranged from 2,001 to 4,000 baht/month, accounting for 48.9% of the sample. The age of onset of substance use varied from 4 to 20 years and differed depending on the type of drug use. The prevalence rates of substance use among the sample group for lifetime of, past 12 months, past 3 months, and past 1 month were 70.7%, 65.5%, 57.5%, and 49.7%, respectively. The top five substances used in the past 12 months were alcohol, electronic cigarettes, cigarettes, kratom leaves, and kratom cocktails, with prevalence rates of 52.5%, 38.9%, 28.9%, 16.6%, and 14%, respectively. Females had higher prevalence rates of using alcohol and electronic cigarette, compared to males in the past 3 months. The results of the mixed-methods study confirm that factors influencing the drug use behavior of students in the eastern region include having close friends who currently use drugs (AOR = 5.54, 95% CI = 4.18-7.34, p < .001), having a partner who currently uses drugs (AOR = 2.19, 95% CI = 1.35-3.59, p < .05), and difficulty in controlling impulses (AOR = 1.05, 95% CI = 1.01-1.10, p < .05). These findings indicate higher substance use behaviors among vocational students compared to others, especially electronic cigarettes. Relevant agencies at both national and vocational education institutions can utilize these research findings to develop prevention, control, and harm reduction models for substance use behaviors among vocational students.