Prevalence, perceived effects, and motivations for adolescent e-cigarette use: A cross-sectional study in the Paris region.

Abstract

Introduction: Adolescence is a critical period for experimentation with psychoactive substances, including electronic cigarettes (e-cigarettes). This study aimed to assess the prevalence of e-cigarette use among high school students in Paris and to explore adolescents' motivations for use and their perceptions of its effects.

Methods: This cross-sectional study, based on self-reported data collected through an online questionnaire, was conducted between January and April 2021 among students from six educational institutions in the Paris region. The anonymized survey collected demographic and health data, information on tobacco and e-cigarette use behaviors, and perceptions and motivations related to e-cigarette use. Associations between the social environment and tobacco and e-cigarette experimentation were evaluated using prevalence ratios, crude odds ratios (ORs), and adjusted ORs (AORs), with 95% confidence intervals (CIs).

Results: A total of 1187 students participated (median age: 17 years; 55.5% male). E-cigarette experimentation was reported by 46.8%, current use by 18.9%, and daily use by 8.6%. The mean age at e-cigarette initiation was 14.9±1.9 years. Dual experimentation with tobacco and e-cigarettes was observed in 39.2% of participants, while 5.2% reported exclusive e-cigarette use. Curiosity was the most frequently reported motivation for e-cigarette ever users (91.4%), followed by flavor variety (75.0%), and the ability to use e-cigarettes at home without tobacco odor (63.6%). Exposure to e-cigarette use among friends was strongly associated with e-cigarette experimentation (AOR=3.68; 95% CI: 2.88-4.73). Notably, 23.4% of all respondents and 12.3% of e-cigarette ever users were unaware whether e-liquids contained nicotine. Most e-cigarette users expressed concerns about lung health (85.2%) and addiction risk (75.5%).

Conclusions: E-cigarette use is prevalent among adolescents in the Paris region and is driven by curiosity, sensory appeal, and social influences. Additional studies, particularly longitudinal cohort studies, are needed to provide evidence-based information on tobacco and e-cigarette use trajectories among adolescents.