Perception of e-cigarette as a harmful product delays initiation by two years among Mexican students aged 14-29 years.

BACKGROUND: Electronic cigarette consumption has increased worldwide. In Latin America, multiple gaps exist regarding health policies on manufacturing and restriction of electronic cigarette use. Although previous research studies have characterized current e-cigarette use in Mexico, few studies have reported e-cigarette use among students, and there is a need to update this information. Therefore, this study aimed to identify the perceptions, current use, knowledge, and factors associated with electronic cigarette consumption among Mexican students aged 14–29 years. METHODS: This is and observational, cross-sectional, survey-based analytical study carried out in public and private schools in Mexico. In total, 8,164 students responded to the survey. Surveys were provided on the Google forms™ platform and were answered through a mobile device by scanning a QR code. The survey collected data on the respondents’ knowledge about electronic cigarettes, and factors associated with their consumption. FINDINGS: The mean age of participants was 17.3 ± 2.4 years (range: 14–29 years). Study found 31.4% of the students had used electronic cigarettes, and 22.9% were current users. The average age of initiation of electronic cigarette consumption was 21 years. Furthermore, 9 out of 10 students considered vaping harmful, but 24% were not aware of its contents. The main reason for consumption was exploration of flavors. Students from private institutions initiated electronic cigarette consumption at an earlier age than those from public schools (p < 0.001). Electronic cigarette use preceded tobacco-use in 50% of smokers starting by 17 years of age. Finally, students who recognized the harmful effects of electronic cigarettes delayed initiation by ≥ 2 years (p < 0.001). INTERPRETATION: The school environment, tobacco use, and perception of the adverse effects of electronic cigarette were significantly associated with the age of electronic cigarette initiation.