Factors associated with electronic cigarette use among current cigarette-smoking adolescents in the Republic of Korea

Objective: Despite a rapid increase in electronic cigarette (e-cigarette) use and substantial dual use of cigarettes and e-cigarettes among adolescents, little is currently known about adolescent e-cigarette use. Thus, this study aimed to investigate (a) rates of e-cigarette use and (b) significant factors associated with e-cigarette use among current cigarette users in adolescence. Methods: We analyzed secondary data collected from a nationally representative sample of Korean adolescents. Our study sample included 6307 current smokers. Our dependent variable was e-cigarette use and consisted of three categories (nonuse, former use, and current use); independent variables included demographics, perceived stress, parental and friends' smoking, three characteristics of cigarette smoking, and other health risk behaviors. Descriptive statistics was used for the first aim; multinomial logistic regression analysis was performed for the second aim. Results: Of current cigarette users, 20% smoked e-cigarettes in their lifetime but not within the past 30 days (former users), and 42% smoked e-cigarettes in their lifetime and within the past 30 days (current users). Both former and current e-cigarette use were significantly associated with male gender, higher grades, higher weekly allowance, residence in urban areas, friends' smoking, daily smoking, a higher number of cigarettes smoked, and quit attempts. In addition, current e-cigarette use was significantly associated with at-risk drinking, lifetime drug use, and lifetime sexual intercourse. Conclusions: E-cigarette use should be included in intervention strategies for smoking prevention and cessation. Strict regulations should be implemented in order to prohibit easy access to e-cigarettes and forbid advertising of e-cigarettes as well. (C) 2017 Elsevier Ltd. All rights reserved.