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Background: E-cigarette use was associated with health effects, including lung injury. This cross-sectional study aimed to assess the university students’ health belief in e-cigarette use associated with lung injury based on the Health Belief Model (HBM). Methods: We collected data using an online self-administered questionnaire from December 2020 to February 2021 from university students at two universities in northern Thailand who were currently using e-cigarettes. The HBM was measured using questions with a 4-Likert-scale answer (1=strongly disbelieve,2=disbelieve,3=believe,4=strongly believe), then the answers were categorized into 2 groups (belief and disbelief). Results: Of 306 students (61% men, the mean age of 21.8 3.0 years), 53% used both e-cigarettes and conventional cigarettes, and 47% used only e-cigarettes. It showed that 74% of students believed that if they used e-cigarettes, they were at risk of lung injury (HBM: perceived susceptibility), and 68% believed that they had a chance to die from lung injury caused by using e-cigarettes (HBM: perceived severity), and 76% believed that quitting e-cigarettes could reduce the chance of death from lung injury (HBM: perceived benefits). Most students (62%) believed that the strongest barrier for quitting e-cigarettes was that it required a high effort and strong intention (HBM: perceived barriers of quitting e-cigarette), and 76% of students perceived their self-efficacy and believed that when they intended to quit e-cigarettes, they would be successful (HBM: perceived self-efficacy). Most participants believed that family members (78%), lovers (75%), and university restrictions (53%) exerted a positive influence in quitting e-cigarettes (HBM: cues to action). Conclusions: The HBM helps us to understand using e-cigarettes associated with lung injury among university students. The university should initiate health promotion activities concerning reducing e-cigarettes use among adolescents and young adults. Key messages: Using e-cigarettes is dangerous for health including lung injury, and university students should stop using e-cigarettes. The university should initiate or enhance prevention and health promotion activities concerning reducing e-cigarettes use among adolescent and young adults. [ABSTRACT FROM AUTHOR]