{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:41:14Z","timestamp":1784590874202,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objectives of this study were to investigate electronic cigarette (e-cigarette) and cigarette use in Jiangsu Province, China, by analyzing the two-year trends of e-cigarette using and to explore the factors influencing the experimentation and use of e-cigarettes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross-sectional study following the standard methodology of the Global Youth Tobacco Survey in 2019 and 2021. A three-stage cluster sampling design was applied. Eighty-two schools in 14 districts (counties) in Jiangsu Province were surveyed. All computations were performed using the SPSS 21.0 complex samples procedure. Multivariate logistic regression was used to explore the factors influencing e-cigarette experimentation and use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12,410 and 12,880 students were surveyed in 2019 and 2021, respectively. E-cigarette experimentation increased from 9.34% in 2019 to 13.07% in 2021 (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). E-cigarette use increased from 2.23% in 2019 to 3.74% in 2021 (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). The main factors associated with e-cigarette use were cigarette experimentation (OR = 2.700, <jats:italic>P<\/jats:italic> &amp;lt; 0.001); male gender (OR = 1.416, <jats:italic>P<\/jats:italic> = 0.011); junior high school students (OR = 1.551, <jats:italic>P<\/jats:italic> = 0.005) and vocational high school students (OR = 1.644, <jats:italic>P<\/jats:italic> = 0.001); more pocket money per week (OR<jats:sub>1<\/jats:sub> = 1.214, <jats:italic>P<\/jats:italic> = 0.187; OR<jats:sub>2<\/jats:sub> = 1.686, <jats:italic>P<\/jats:italic> = 0.001); exposure to second-hand smoke (SHS) at home (OR = 1.239, <jats:italic>P<\/jats:italic> &amp;lt; 0.001); exposure to e-cigarette advertising (OR = 1.855, <jats:italic>P<\/jats:italic> &amp;lt; 0.001); believe SHS is harmful (OR = 0.933, <jats:italic>P<\/jats:italic> = 0.026); closest friends smoking (OR = 2.501, <jats:italic>P<\/jats:italic> &amp;lt; 0.001); believe smoking makes youth look more attractive (OR<jats:sub>1<\/jats:sub> = 1.469, <jats:italic>P<\/jats:italic> = 0.040; OR<jats:sub>2<\/jats:sub> = 1.305, <jats:italic>P<\/jats:italic> = 0.049); believe tobacco helps youth feel more comfortable in social situations (OR<jats:sub>1<\/jats:sub> = 2.161, <jats:italic>P<\/jats:italic> &amp;lt; 0.001; OR<jats:sub>2<\/jats:sub> = 1.635, <jats:italic>P<\/jats:italic> = 0.001); will use an e-cigarette product if offered by best friends (OR = 1.322, <jats:italic>P<\/jats:italic> &amp;lt; 0.001); intend to use an e-cigarette product in the next 12 months (OR = 1.486, <jats:italic>P<\/jats:italic> &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>E-cigarette use among adolescents has been on the rise in recent years. E-cigarette use is associated with past cigarette use and a strong desire to smoke. It is crucial to take health education and tobacco control efforts to reduce adolescents' e-cigarette use rate.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1221334","type":"journal-article","created":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T17:05:17Z","timestamp":1701536717000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparative analysis of e-cigarette prevalence and influencing factors among adolescents in Jiangsu Province, China"],"prefix":"10.3389","volume":"11","author":[{"given":"Jiannan","family":"Fan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqi","family":"Zhen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.15585\/mmwr.mm6438a1","article-title":"Frequency of tobacco use among middle and high school students\u2013United States, 2014","volume":"64","author":"Neff","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7105a1","article-title":"Tobacco product use and associated factors among middle and high school students - National Youth Tobacco Survey, United States, 2021","volume":"71","author":"Gentzke A","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/1747-597X-7-38","article-title":"Smoking among adolescents in Northern Greece: a large cross-sectional study about risk and preventive factors","volume":"7","author":"Spyratos","year":"2012","journal-title":"Subst Abuse Treat Prev Policy."},{"key":"B4","doi-asserted-by":"publisher","first-page":"106131","DOI":"10.1016\/j.addbeh.2019.106131","article-title":"Parents modelling, peer influence and peer selection impact on adolescent smoking behavior: a longitudinal study in two age cohorts","volume":"100","author":"Vit\u00f3ria","year":"2020","journal-title":"Addict Behav"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0222572","DOI":"10.1371\/journal.pone.0222572","article-title":"The impact of peer pressure on cigarette smoking among high school and university students in Ethiopia: a systemic review and meta-analysis","volume":"14","author":"Leshargie","year":"2019","journal-title":"PLoS ONE."},{"key":"B6","doi-asserted-by":"publisher","first-page":"328","DOI":"10.4187\/respcare.06300","article-title":"Impact of electronic cigarettes on various organ systems","volume":"64","author":"Eltorai","year":"2019","journal-title":"Respir Care."},{"key":"B7","doi-asserted-by":"publisher","first-page":"4057","DOI":"10.1093\/eurheartj\/ehaa460","article-title":"Effects of tobacco cigarettes, e-cigarettes, and waterpipe smoking on endothelial function and clinical outcomes","volume":"41","author":"M\u00fcnzel","year":"2020","journal-title":"Eur Heart J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1080\/17476348.2020.1807332","article-title":"Could E-cigarette vaping contribute to heart disease?","volume":"14","author":"Kuntic","year":"2020","journal-title":"Expert Rev Respir Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1146\/annurev-pharmtox-042921-084202","article-title":"E-cigarette toxicology","volume":"62","author":"Gordon","year":"2022","journal-title":"Annu Rev Pharmacol Toxicol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1093\/ntr\/ntt200","article-title":"Noncombustible tobacco product advertising: how companies are selling the new face of tobacco","volume":"16","author":"Richardson","year":"2014","journal-title":"Nicotine Tob Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1001\/jamapediatrics.2014.2898","article-title":"Electronic cigarette use and exposure in the pediatric population","volume":"169","author":"Collaco","year":"2015","journal-title":"JAMA Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1093\/ntr\/ntu081","article-title":"E-cigarette availability and promotion among retail outlets near college campuses in two southeastern states","volume":"16","author":"Wagoner","year":"2014","journal-title":"Nicotine Tob Res."},{"key":"B13","first-page":"28973","article-title":"Restrictions on the sale and distribution of tobacco products and required warning statements for tobacco products. 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