ArticleTobacco control2024
Exclusive and dual use of electronic cigarettes among European youth in 32 countries with different regulatory landscapes.
Article in Tobacco control, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Cardiovascular disease in women: traditional and sex-specific risk factors.European heart journal · 2026Review
- Gender trends in youth tobacco and nicotine use in Georgia across GYTS rounds, 2014-23.European journal of public health · 2026Article
- Prevalence and factors associated with e-cigarettes consumption among adolescents: A cross-sectional analysis in Latin America and the Caribbean.PLOS global public health · 2026Article
- Tobacco use perceptions and intentions to abstain among adolescents in the English-speaking Caribbean: A cross-sectional secondary analysis.Tobacco prevention & cessation · 2026Article
- Prevalence and patterns of e-cigarette use among school-aged adolescents in Peru, 2024.Tobacco induced diseases · 2026Article
- Perceptions of e-Cigarettes and Heated Tobacco Products Among Never Users of Nicotine in the European Union.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Prevalence, risk perception, and motivations behind E-cigarettes and heated tobacco use: a cross-sectional study in Italian adolescents.Italian journal of pediatrics · 2025Article
- Article
- Decision to use e-cigarettes and associated factors among students of a university in Northern Thailand.Tobacco induced diseases · 2025Article
- A systematic review on risk factors and reasons for e-cigarette use in adolescents.Tobacco induced diseases · 2025Review
- The Vaper's Perspective: A Qualitative Study of E-Cigarette Users and Smokers in Slovenia.Zdravstveno varstvo · 2024Article
- The potential impact of removing a ban on electronic nicotine delivery systems using the Mexico smoking and vaping model (SAVM).medRxiv : the preprint server for health sciences · 2024Article
- E-cigarette use in low-income and middle-income countries: opportunity or challenge for global tobacco control.The Lancet. Global health · 2023Article
- Knowledge, Attitude, and Practice of E-Cigarettes of Adolescents and Adults in Saudi Arabia: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2023Article
- Electronic Cigarette Harms: Aggregate Evidence Shows Damage to Biological Systems.International journal of environmental research and public health · 2023Review
- Electronic cigarettes: "wolves in sheep's clothing".Jornal de pediatriaReview
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe Tobacco Products Directive (2014/40/EU) partially harmonised the regulation of electronic cigarettes (e-cigarettes) in Europe, but individual countries maintain jurisdiction over bans on use in public places, domestic advertising, taxation and flavour regulations. Their association with youth e-cigarette use has not been examined.
methodsWe used the cross-sectional 2019 European School Survey Project on Alcohol and Other Drugs data from 32 countries with 98 758 students aged 15-16 years and the 2020 WHO's assessment of the e-cigarette regulations. Multilevel logistic regression models on ever (vs never) and current (vs non-current) exclusive e-cigarette use, exclusive cigarette use and dual use by e-cigarette regulations' composite score were adjusted for age, gender, parental education, perceived family's financial well-being, perceived difficulty of obtaining cigarettes, country income level and general progress in tobacco control.
resultsOf the respondents, 13.3% had ever used cigarettes, 10.6% e-cigarettes and 27.3% both; 13.0% currently used cigarettes, 6.0% e-cigarettes and 6.4% both. Higher composite country score in the e-cigarette regulations was associated with lower current exclusive e-cigarette use (OR=0.78; 95% CI 0.65 to 0.94) and current dual use (OR=0.80; 95% CI 0.67 to 0.95). Youth perceiving more difficulties in obtaining cigarettes were less likely to use cigarettes, e-cigarettes and both ever and currently (OR from 0.80 (95% CI 0.76 to 0.85) to 0.94 (95% CI 0.92 to 0.96)).
conclusionsMore comprehensive e-cigarette regulations and enforcement of age-of-sale laws may be protective of e-cigarette and dual use among adolescents.
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