Addictive behaviors, social and psychosocial factors, and electronic cigarette use among adolescents: a population-based study

Objectives: The aim was to investigate associations between e-cigarette use and social and psychosocial factors and cigarette smoking, alcohol consumption, and narcotics use among adolescents attending 9th grade in primary school and 2nd grade in secondary school. Study design: Cross-sectional study. Methods: The public health survey among adolescents in Scania in 2016 includes pupils in grades 9 and 2. The associations between e-cigarette use and lifestyle, social and psychosocial factors, and trust were investigated with logistic regressions. Results: In 9th grade, 32% of male pupils and 27% of female pupils had ever used e-cigarettes, and in 2nd grade, 43% of males and 31% of females had ever used e-cigarettes. E-cigarette use was significantly associated with current smoking, snus (a moist powder tobacco product originating in Sweden) use, water pipe use, intensive alcohol consumption, and narcotics and also with psychosocial conditions related to home and parents, peers, and school. Conclusions: The prevalence of ever e-cigarette use was high among adolescents attending both grades. E-cigarette use was most strongly associated with health-related lifestyles. It was also associated with psychosocial factors such as study difficulties, school stress, problems talking with parents, and generalized trust.