What differentiates youths who use e-cigarettes from those who smoke traditional tobacco products?

BACKGROUND: Electronic cigarette (e-cigarette) use has spread among adolescents in many countries, however users' characteristics are not well known. We aimed to compare characteristics of exclusive e-cigarette users to those of exclusive tobacco users and dual users. METHODS: Data come from a representative sample of 11-19 years old students in Paris, surveyed each year between 2013 and 2017. Current e-cigarette and tobacco use were ascertained in the preceding 30 days. Data were analyzed using random intercept multinomial logistic regression models, exclusive tobacco smokers being the reference group. RESULTS: Among the 17,435 students included, 2.3% reported exclusive e-cigarette use, 7.9% exclusive tobacco use and 3.2% dual e-cigarette and tobacco use. Compared to exclusive tobacco smokers, e-cigarette users were: a) less likely to use cannabis (adjusted Odds-Ratio (aOR) = 0.15, 95% confidence interval (95% CI) = 0.09-0.25); b) more likely to initiate smoking with an e-cigarette or a hookah rather than traditional cigarettes (aOR = 2.91, 95% CI = 1.74-4.87 and aOR = 15.99, 95% CI = 8.62-29.67, respectively). Additionally, exclusive e-cigarette users are younger with an aOR = 0.29 (95% CI = 0.17-0.49) among 13-15 years and aOR = 0.11 (95% CI = 0.06-0.21) among > 17 years as compared to 11-13 years. The probability of being an exclusive e-cigarette user is lower among participants whose best friend smokes tobacco (aOR = 0.30, 95% CI = 0.20-0.44). Exclusive tobacco users and dual users have similar profiles. CONCLUSIONS: Adolescents who only used e-cigarettes had intermediate levels of risk compared to nonusers and those who used tobacco and/or e-cigarettes, suggesting that e-cigarettes use extends to young people at low-risk of using tobacco products.

Secondhand smoke exposure in hospitality venues in Europe.

BACKGROUND: Although in the last few years some European countries have implemented smoking bans in hospitality venues, the levels of secondhand smoke (SHS) in this occupational sector could still be extremely high in most countries. OBJECTIVE: The aim of this study was to assess exposure to SHS in hospitality venues in 10 European cities. METHODS: We included 167 hospitality venues (58 discotheques and pubs, 82 restaurants and cafeterias, and 27 fast-food restaurants) in this cross-sectional study. We carried out fieldwork in 10 European cities: Vienna (Austria), Paris (France), Athens (Greece), Florence and Belluno (Italy), Galway (Ireland), Barcelona (Spain), Warsaw and Lublin (Poland), and Bratislava (Slovak Republic). We measured vapor-phase nicotine as an SHS marker. RESULTS: We analyzed 504 samples and found nicotine in most samples (97.4%). We found the highest median concentrations in discos/pubs [32.99 microg/m(3); interquartile range (IQR), 8.06-66.84 microg/m(3)] and lower median concentrations in restaurants/cafeterias (2.09 microg/m(3); IQR, 0.49-6.73 microg/m(3)) and fast-food restaurants (0.31 microg/m(3); IQR, 0.11-1.30 microg/m(3)) (p < 0.05). We found differences of exposure between countries that may be related to their smoking regulations. Where we sampled smoking and nonsmoking areas, nicotine concentrations were significantly lower in nonsmoking areas. CONCLUSIONS: Hospitality venues from European cities without smoking regulations have very high levels of SHS exposure. Monitoring of SHS on a regular basis as well as a total smoking ban in hospitality sector would be needed.

Factors associated with experimentation of electronic cigarettes among Parisian teenagers in 2013.

BACKGROUND: Electronic cigarettes (e-cig.) became widely used among adults. Data are insufficient about e-cig. experimentation among youth. METHODS: To assess prevalence of e-cig. experimentation and associated factors among the 12 to 19 years old we analyse a cross sectional school based survey in the city of Paris, France in 2013 on a randomly selected sample of 2 % of schoolchildren (n = 3 279). Self-report questionnaire include demographic, individual and family smoking characteristics and questions about e-cig: "Have you ever used an e-cigarette?"- "Did you use e-cigarette in the last 30 days?"-"Did you try e-cigarette as a first tobacco product?". RESULTS: In 2013, 17.9 % (564) schoolchildren reported having experienced the e-cig (boys: 19.0 %, girls: 16.8 %) compared to 9.8 % in 2012. Experimentation rate increases from 5 % among the 12 to 30 % among the 16-year-old. E-cig. experimentation was significantly associated with 11 parameters including : age >15 years (OR: 0.66 (IC95 % = 0.46-0.94)); smoking 10 cigarettes or more (OR = 5.67 (IC95 % = 3.11-10.34)), best friends and siblings smoker (OR = 1.54 (IC95 % = 1.11-2.14)) and (OR = 1.88 (IC95 % = 1.41-2.52)); experimentation of shisha (OR = 2.60 (IC95 % = 1.75-3.86)), cannabis use (OR = 1.90 (IC95 % = 1.32-2.72)); having two parents who forbid smoking (OR = 2.32 (IC95 % = 1.63-3.30)). Only 5.6 % of the study population (and 32.5 % of e-cig. experimenters (183/564)) have used it in the last 30 days; 1.7 % of the study population and 10.0 % of e-cig. experimenters were non-smokers (56/564). CONCLUSIONS: Rate of e-cig. experimentation among schoolchildren increased by 8.1 % in 1 year. Non-smoking youth may use e-cig. Prospective studies are urgently needed to assess the evolution of e-cig. use both among smoking and non-smoking youth.