Suicidal Ideation and Associated Health Risk Behaviors among Korean Adolescents with E-Cigarette Experience: A Gender-Based National Cross-Sectional Study.

Adolescent e-cigarette use is increasing worldwide and is associated with other health risk behaviors and mental health problems with gender differences. This study examined gender-specific factors associated with suicidal ideation among Korean adolescents with e-cigarette experience. Using data from the 2024 Korean Adolescent Health Behavior Survey, we analyzed 3863 adolescents (2510 boys and 1353 girls) with e-cigarette experience. Complex sample logistic regression analysis was applied to identify factors associated with suicidal ideation. For both genders, habitual and intentional drug use and hospitalization due to violence were significantly associated with higher odds of suicidal ideation. Among girls, cigarette smoking was significantly associated with suicidal ideation, whereas among boys, alcohol consumption showed only a marginal association before Bonferroni correction. To our knowledge, this is the first study to investigate the associations between health risk behaviors and suicidal ideation among adolescents with e-cigarette experience. The findings highlight the need for gender-sensitive suicide prevention strategies for adolescent e-cigarette users.