Do high achievers have the same relationship with e-cigarettes as with cigarettes?
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Tobacco Free Research Institute Ireland, Dublin, Ireland
Publication date: 2022-07-05
Tob. Prev. Cessation 2022;8(Supplement):A78
An inverse association between teenage smoking and academic achievement is long established. Little is known about e-cigarettes and achievement.

To examine associations between teenage academic achievement and lifetime/current smoking, and current e-cigarette use, in the same sample.

ESPAD (European Schools Project for Alcohol and Other Drugs) has surveyed students since 1995 on substance use, including cigarette smoking. In 2019, in Ireland, 1967 students, born in 2003, were surveyed from a stratified random sample of 50 Irish schools. Variables included student achievement measured by their average grade [categorized from very high (A and B) to very low (E or lower)], lifetime smoking, current smoking, and current e-cigarette use. Descriptive and bivariate analyses were carried out using Stata version 16.

Students’ average grade was significantly associated with lifetime and current smoking. In all, 75.4% (n=645) of high-achieving students (average grades mostly A and B) had never smoked in their lifetimes or in the past 30 days (91.6%, n=784). Only 3.3% (n=28) of high-achieving students had ever smoked more than 40 cigarettes and smoked everyday (1.9%, n=16). Conversely, those who reported lower average grades smoked more both in their lifetimes and every day. A strong association was also observed between achievement and current e-cigarette use; 86.8% (n=743) of high-achieving students had never used e-cigarettes compared to 61.1% (n=22) who scored E or lower. Only 2% (n=17) of high-achieving students used e-cigarettes every day. However, the most high-achieving students (A or B grades) were less likely to be non-e-cigarette current users (86.8%, n=743) than to be noncurrent smokers (91.6%, n=784), suggesting that, for these high achievers, e-cigarettes are more acceptable than cigarettes.

As with cigarettes, we find a similar inverse association between achievement and e-cigarette use. This has implications for health education.