Title: E-cigarettes and smoking in Irish teens: A logistic regression analysis of current (past 30-day) use of e-cigarettes

Abstract Aim: Electronic cigarette use among Irish teenagers has risen significantly. In 2019, prevalence of current use (last 30 days) among 15-17-year olds was 17.3%. We examine social determinants of adolescent e-cigarette current use. Subject and Methods: A stratified random sample of 50 schools in Ireland was surveyed in 2019, part of the European School Survey Project on Alcohol and other Drugs (ESPAD), with 3,495 students aged 15, 16 and 17. Bivariate and multivariable logistic regression (providing adjusted odds ratios (AORs)) analyses were performed using Stata version 16. Results: Current e-cigarette users were more likely to be male (AOR=0.55, 95% CI:0.32-0.96, p<.01), younger (AOR=0.34, 95% CI:0.17-0.67, p=<.05), to participate in sport (AOR=2.21, 95% CI:1.05-4.65, p<.05), to have higher-educated parents (maternal higher education: AOR=27.54, 95% CI:1.50-505.77, p=<.05, paternal higher education: AOR=2.44, 95% CI:1.00-5.91, p<.05), and less likely to consider their families better off (AOR=0.29, 95% CI:0.13-0.65, p<.01), or to report familial support (AOR=0.78, 95% CI:0.64-0.95, p<.05). They were more likely to be cigarette smokers (AOR=7.22, 95% CI:3.97-13.12, p<.001), to report problem cannabis use (AOR=3.12, 95% CI:1.40-6.93, p<.01), to be ‘binge’ drinkers (AOR=1.81, 95% CI:1.00-3.32, p=.054), and to have friends who get drunk (AOR=5.30, 95% CI:1.34-20.86, p<.05). Conclusion: Boys, smokers, binge drinkers, problem cannabis users, and sport-playing teenagers from higher-educated families, are at particular risk. As the number of young people using e-cigarettes continues to rise, including teenagers who have never smoked, improved regulation of e-cigarettes, similar to other tobacco-related products, is needed urgently to prevent this worrying new trend of initiation into nicotine addiction.