BACKGROUND: Electronic cigarettes (E-cigarettes) contain chemicals with some known to be carcinogens. E-cigarette vapour may have cardiovascular and pulmonary ill-effects. Some e-liquid has nicotine that has been negatively associated with the brain development. E-cigarette use has also been associated with initiation of tobacco smoking which is a major cause of morbidity and mortality worldwide. The current study presents the first ever reported prevalence of e-cigarette use and its correlates in Zambia.
METHODS: We used data from the Global Youth Tobacco Survey 2021 conducted in 2021 in Zambia. A total of 8,336 were invited to participate in the survey and were selected using a two-stage cluster sampling method. Adjusted Odds ratio and 95% confidence intervals were used to establish associations.
RESULTS: A total of 6,499 adolescent students participated in the study, giving a response rate of 75.7%. The prevalence of e-cigarette use was 20.0% (19.5% for males and 19.9% for females). Major factors positively associated with current smoking of electronic cigarettes were: current cigarette smoking (AOR=3.00, 95% CI: 2.95, 3.05), ever smoked cigarette (AOR=1.83, 95% CI: 1.81, 1.86), ever smoked shisha (AOR=1.57, 95% CI: 1.55, 1.59), father smokes about every day in the house (AOR=1.59, 95% CI: 1.56, 1.61), and exposure to environmental tobacco smoke (AOR=2.01, 95% CI: 2.00, 2.04). A major protective factor was having no closest friends who smoke tobacco (AOR=0.31, 95% CI: 0.30, 0.31).
CONCLUSIONS: The observed rate of electronic cigarette use among adolescents is concerning in Zambia and necessitates a comprehensive package of interventions considering the observed risk factors in the current study.