Longitudinal analysis of predictors of electronic cigarette trial among adolescents in Guatemala

Understanding factors influencing electronic cigarette (e-cigarette) trial in adolescents is crucial for shaping policies and interventions to reduce consumption and potentially prevent addictive tendencies, particularly in countries with weak regulations like Guatemala.

We aimed to longitudinally assess predictors of e-cigarette trial among Guatemalan adolescents surveyed in 2019, 2020, and 2021.

Students (13 to 18 years old) from nine private schools completed self-administered questionnaires about e-cigarette use and associated risk factors. Data from those who had at least one follow-up survey after reporting that they had never tried e-cigarettes at either the 2019 or 2020 survey (N = 838) was analyzed. We used a mixed-effects logistic regression clustered by student and school to assess predictors of ever e-cigarette use.

Nearly one-quarter (21.0 %) of unique students tried e-cigarettes at follow-up. Risk factors for e-cigarette trial included cigarette or heated tobacco products use (adjusted odds ratio [AOR] = 2.95, 95 %CI = 1.24-7.04), frequent exposure to online e-cigarette marketing (AOR = 2.46, 95 %CI = 1.39-4.35), alcohol or marihuana use (AOR = 1.74, 95 %CI = 1.17-2.58), and parental approval of e-cigarette use (AOR = 1.65, 95 %CI = 1.14-2.40). The perception that serious illness from life-long e-cigarette use is likely or certain (AOR = 0.57, 95 %CI = 0.36-0.91, and AOR = 0.37, 95 %CI = 0.19-0.72, respectively) appeared as a protective factor for e-cigarette trial.

Our findings align with international research, indicating shared risk factors across youth worldwide. The incorporation of these factors into policies and interventions targeting the reduction of e-cigarette trial is imperative for optimizing their efficacy.