Evolution of Tobacco and E-cigarette Experimentation and Use Among French Adolescents Aged 15-16 Years From 2018 to 2020: A Cross-sectional Observational Study

Background: We assessed and compared the evolution of tobacco and e-cigarette experimentation and use among French adolescents aged 15-16 years. Methods: . A descriptive, cross-sectional, observational study conducted in 2018-2020 among 7,883 Year 11 pupils attending 27 public secondary schools of the Loire department, France. Results: . From 2018 to 2020, 66.18% of adolescents were “non-vapers and non-smokers”, 19.76% were “vapers and smokers”, 7.90% were “non-vapers and smokers” and 6.15% were “vapers and non-smokers”. E-cigarette experimentation was more prevalent than tobacco experimentation (44.92% vs 41.67%), and daily vaping was less prevalent than daily smoking (5.40% vs 10.24%). More boys than girls were daily vapers or daily smokers. A decrease was observed in tobacco experimentation (from 41.22% in 2018 to 39.73% in 2020) and e-cigarette experimentation (from 50.28% in 2018 to 41.25% in 2020). Current vaping remained stable, with an increase in daily vaping. French adolescent vapers frequently use e-liquids with little or no nicotine or with fruit or sweet flavours. Conclusions: . Adolescents used e-cigarettes mainly for experimental and/or recreational purposes. The proportion of “non-vapers and non-smokers” tended to increase. “Non-vapers and smokers” tended to progress to the dual use of vaping and smoked tobacco products, with the likely intention to reduce or quit smoking.