Lifetime and active use of electronic cigarettes among Brazilian adolescents: The 2019 national school health survey - PeNSE 2019

Objectives: To investigate the prevalence and the factors associated with experimentation and use of e-cigarettes.

Study design: Cross-sectional study.

Methods: Cross-sectional analysis of data from the National School Health Survey (PeNSE 2019), with students attending elementary school and high school in Brazil. Two outcomes were investigated: experimentation and last 30-day use of e-cigarettes. Potential exposures included family and adolescents' socio-demographic, mental health, and behavioral characteristics. Adjusted prevalence ratios (PR) were obtained by Poisson regression with robust variance.

Results: 133,237 adolescents aged ≥13 years were included. Prevalence of experimentation and last 30-day use was higher in males (20.7 % and 4.1 %, respectively) than in females (15.4 % and 2.6 %, respectively). The higher PR were with ever use of hookah in males (PR = 3.34 for e-cigarettes experimentation and PR = 4.05 for last 30-day use) and females (PR = 3.26 for experimentation and PR = 4.14 for last 30-day use). For males who ever used alcoholic beverages, the PR for e-cigarettes experimentation ranged from 2.86 to 3.18, and the PR for last 30-day use ranged from 3.09 to 3.39, depending upon the age of first alcoholic beverage experimentation. Among the females who ever used alcoholic beverages, PR for experimentation ranged from 3.46 to 4.31 and PR for last 30-day use ranged from 2.44 to 4.09.

Conclusion: About a quarter of school age adolescents had already tried e-cigarettes and 3.4 % used e-cigarettes in the prior 30 days. There were sex differences in the prevalence and in factors associated with experimentation and last 30-day use of e-cigarettes.