Reported electronic cigarette use among adolescents in the Niagara region of Ontario
Background: Use of electronic cigarettes (e cigarettes) among adolescents has not been fully described, in particular their motivations for using them and factors associated with use. We sought to evaluate the frequency, motivations and associated factors for e cigarette use among adolescents in Ontario. Methods: We conducted a cross sectional study in the Niagara region of Ontario, Canada, involving universal screening of students enrolled in grade 9 in co operation with the Heart Niagara Inc. Healthy Heart Schools' Program (for the 2013 2014 school year) We used a questionnaire to assess cigarette, e cigarette and other tobacco use, and self rated health and stress. We assessed household income using 2011 Canadian census data by matching postal codes to census code. Results: Of 3312 respondents, 2367 answered at least 1 question in the smoking section of the questionnaire (1274 of the 2367 respondents [53.8% were male, with a mean [SD] age of 14.6 [0.5] yr) and 2292 answered the question about use of e cigarettes. Most respondents to the questions about use of e cigarettes (n 1599, 69.8% had heard of e cigarettes, and 380 (23.8% of these respondents had learned about them from a store sign or display. Use of e cigarettes was reported by 238 (10.4% students. Most of the respondents who reported using e cigarettes (171, 71.9% tried them because it was "cool/fun/new," whereas 14 (5.8% reported using them for smoking reduction or cessation. Male sex, recent cigarette or other tobacco use, family members who smoke and friends who smoke were strongly associated with reported e cigarette use. Reported use of e cigarettes was associated with self identified fair/poor health rating (odds ratio [OR] 1.9 (95% confidence interval [CI] 1.2 3.0) p 0.001) high stress level (OR 1.7 (95% CI 1.1 2.7) p 0.001) and lower mean (33.4 [8.4] x $1000 v. 36.1 [10.7] x $1000, p 0.001) and median [interquartile range] (26.2 [5.6] x $1000 v. 28.1 [5.7] x $1000) household incomes. Interpretation: Use of e cigarettes is common among adolescents in the Niagara region and is associated with sociodemographic features. Engaging in seemingly exciting new behaviours appears to be a key motivating factor rather than smoking cessation.
Canadian Medical Association Journal