Predictors of electronic cigarette use among Swedish teenagers: a population-based cohort study.

Introduction:
This text is a summary of a research study that aimed to identify predictors of electronic cigarette (e-cigarette) use among teenagers in Sweden. The study is based on a prospective population-based cohort of schoolchildren in northern Sweden who were followed from age 7-8 to 19 years. The study includes data on respiratory symptoms, living conditions, physical activity, diet, health-related quality of life, parental smoking and occupation, and tobacco use.

Key points:

* at age 19, 21.4% of the cohort had ever tried e-cigarettes and 4.2% were current users.
* E-cigarette use was associated with daily smoking, use of snus, and having a smoking father at age 14-15 years.
* In adjusted analyses, current e-cigarette use was associated with daily tobacco smoking at age 14-15 years, attending a vocational art programme, and inversely associated with eating a healthy diet.
* almost one-third of those who had tried e-cigarettes at age 19 years had never been tobacco smokers.

Main message:
The study found that e-cigarette use among teenagers is associated with personal and parental tobacco use, physical inactivity, unhealthy diet, and attending vocational upper secondary education. Importantly, the study also found that almost one-third of those who had tried e-cigarettes at age 19 years had never been tobacco smokers, raising concerns about the potential for e-cigarettes to serve as a gateway to tobacco use. These findings suggest that efforts to prevent e-cigarette use among teenagers should address a range of risk factors and consider the potential for e-cigarettes to contribute to tobacco use.

hedman L, Backman h, Stridsman C, Lundbäck M, andersson M, Rönmark E. Predictors of electronic cigarette use among Swedish teenagers: a population-based cohort study. BMJ open. 2020;10(12):1. doi:10.1136/bmjopen-2020-040683