Perceived content, relationship with tobacco and self-reported reasons for e-cigarette use among adolescents in Europe - findings from ESPAD 2019
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Institute of Public Health of Serbia, Belgrade, Serbia
National Research Council, Institute Of Clinical Physiology, Pisa, Italy
Department Of Epidemiology, Care And Public Health Research Institute (Caphri), Maastricht University, Maastricht, The Netherlands
Publication date: 2023-10-08
Corresponding author
Biljana Kilibarda   

Institute of Public Health of Serbia, Belgrade, Serbia
Tob. Prev. Cessation 2023;9(Supplement 2):A71
A substantial number of e-cigarette users worldwide are adolescents and for many of them e-cigarette is the first contact with nicotine, often because their attractiveness. The objective of this analysis is to explore the reasons for trying, perceived content of e-cigarette and the relationship with tobacco at the onset of use among adolescents in Europe.

Material and Methods:
Data were obtained from European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 2019 in 35 European countries on a total sample of 102,484 students born in 2003.

In 2019, almost every fourth (23%) 16 years old student in ESPAD countries never used tobacco but tried e-cigarettes. This indicator shows high variations across countries with the highest prevalence in Cyprus and Monaco (39%) and Spain and Lithuania (35%) and the lowest in Norway (11%) and North Macedonia and Montenegro (12%), Serbia (13%) and Croatia (14%). Significantly lower percentage (4.2%) of students regularly used tobacco when they first tried e-cigarette. Curiosity was the reason for trying e-cigarette for 30% of the total sample of students, and for 1.7% it was to stop smoking. Almost every third student (33%) in the total sample of students from 13 ESPAD countries that included this question in the survey, thought that the e-cigarette they used contained nicotine. The risk perception of e-cigarettes is low, with 6% of students perceiving trying e-cigarettes once or twice as a great risk.

The results indicate that e-cigarettes are rarely used by adolescents to reduce harm and stop smoking and at the same time point out low risk perception and knowledge on e-cigarette content. Results call for interventions that would reduce attractiveness, raise awareness on the evidence-based findings about these products and at minimum restrict marketing and promotion of e-cigarette to ensure it is aimed at adults.

The authors have no conflicts of interest to disclose.
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