Use of electronic cigarettes among high school students: Associated factors and perceptions of health risks

Abstract

Introduction: The use of electronic cigarettes among adolescents has become an emerging public health issue, driven by social factors, advertising, and the misconception that these devices are less harmful than conventional cigarettes. Objective: To analyze the prevalence and associated factors of electronic cigarette use among high school students, as well as to evaluate their perceptions of health risks. Method: This is a cross-sectional, descriptive and analytical study with a quantitative approach. A total of 557 students from the 1st and 2nd years of high school at a private school in Curitiba (Brazil) participated. Data were collected through a self-administered, anonymous questionnaire. Statistical analysis included univariate tests (Chi-square) and logistic regression to identify predictors of e-cigarette use, with a significance level of 5%. Results: The prevalence of electronic cigarette use was 36.4%. Main associated factors were having friends who used e-cigarettes (100%) and prior experimentation with other tobacco products. Logistic regression identified two independent predictors: previous use of other tobacco products (OR = 7.3; p < 0.001) and number of friends using e-cigarettes (OR = 3.5; p < 0.001). Knowledge of health risks was not associated with reduced use. Conclusion: E-cigarette use among adolescents is strongly associated with social and peer-related factors. Preventive strategies should include continuous intersectoral educational approaches and stronger regulation and enforcement policies.