Prevalence and factors associated with e-cigarette experimentation among adolescents: 2019 National School Health Survey

Contact with nicotine during adolescence can harm one’s short and long-term health. The global use of e-cigarettes is growing, making it crucial to identify factors for controlling this trend. This study sought to estimate the prevalence of e-cigarette experimentation among Brazilian school adolescents and to analyze associated sociodemographic, interpersonal, behavioral and health factors. Cross-sectional study, with data from the 2019 National School Health Survey ( Pesquisa Nacional de Saúde do Escolar – PeNSE), representative of schoolchildren, aged 13 to 17 years, in Brazil, with a sample size of 124,610. The outcome variable was e-cigarette experimentation (lifetime ever use of electronic cigarette). This study focused on sociodemographic, interpersonal, behavioral, and health explanatory variables. A multivariable logistic regression model was also used. The prevalence of e-cigarette experimentation was 16.8% (95% CI 16.2–17.4%). Higher odds occurred among adolescents aged 16 to 17 years (OR: 1.23; 95%CI 1.13–1.35), with a high Household Goods and Services Score (OR: 1.65; 95% CI 1.45–1.89). Lower odds were found among girls (OR: 0.76; 95% CI 0.70–0.84). In the interpersonal context, the highest odds occurred among adolescents who reported sexual abuse (OR: 1.32; 95%CI 1.21–1.43), aggression by parents/guardians (OR: 1.34; 95% CI 1.24–1.46), physical fights (OR: 1.50; 95% CI 1.34–1.69), smoking among friends (OR: 2.85; 95% CI 2.66–3.06), and smoking at home (OR: 1.22; 95% CI 1.13–1.33). Lower odds were found among those who lived with their mother (OR: 0.87; 95% CI 0.77–0.99) and had family supervision (OR: 0.80; 95% CI 0.72–0.88). In the behavioral and health context, adolescents who had already had sexual intercourse (OR: 3.03; 95% CI 2.80–3.28), practiced sufficient physical activity (OR: 1.12; 95% CI 1.03–1.23), negatively self-rated their health (OR: 1.18; 95% CI 1.09–1.27), and felt irritable (OR: 1.27; 95% CI 1.15–1.41) were more likely to try e-cigarettes. Almost one fifth of Brazilian adolescents have already tried e-cigarettes, whose characteristics involve sociodemographic, interpersonal, behavioral and health aspects. These findings highlight the importance of actions that consider these contexts, as they influence adolescent health.