Exclusive and dual use of electronic cigarettes among European youth in 32 countries with different regulatory landscapes.

Introduction:
This text provides an analysis of the relationship between national e-cigarette regulations and e-cigarette use among European youth. The study aims to determine if there is an association between the two factors while considering youth socioeconomic status, perceived strength and enforcement of tobacco age-of-sale laws, country income level, and general tobacco control progress in the country. The text also explores whether the associations differ for ever and current use, and for exclusive e-cigarette use, exclusive cigarette use, or dual use.

Key Points:

* The study used data from the European School Survey Project on alcohol and Other Drugs (ESPaD) from 32 countries with 98,758 students aged 15-16 years.
* The text also used data from the WhO Report on the Global Tobacco Epidemic 2021 and validated it with the WhO European Office for the Prevention and Control of Noncommunicable Diseases.
* The study operationalized ever use and current use of e-cigarettes and cigarettes and created a composite measure of national e-cigarette regulations.
* The study controlled for individual characteristics such as gender, perceived family's financial well-being, parental education, and perceived difficulty of obtaining cigarettes.
* The results showed that a higher composite country score in the e-cigarette regulations was associated with lower current exclusive e-cigarette use and current dual use.
* The study also found that youth perceiving more difficulties in obtaining cigarettes were less likely to use cigarettes, e-cigarettes, and both ever and currently.
* The text concludes that adopting comprehensive e-cigarette regulations may support prevention of use among youth.

Main Message:
The study suggests that implementing comprehensive e-cigarette regulations that address protection from exposure, advertising, taxation, and flavors may be an effective strategy for preventing e-cigarette use among youth. The study also highlights the importance of enforcing age-of-sale laws and regulating flavors, which appear to be protective factors for e-cigarette and dual use among adolescents. Overall, the text emphasizes the need for policymakers to consider the evidence on e-cigarette regulations and their impact on youth use to inform regulatory decisions.

Ollila h, Tarasenko Y, Ciobanu a, Lebedeva E, Raitasalo K. Exclusive and dual use of electronic cigarettes among European youth in 32 countries with different regulatory landscapes. Tobacco control. Published online april 25, 2023. doi:10.1136/tc-2022-057749