Risk for teen e-cigarette use higher among boys vs. girls

Risk for e-cigarette use by teenagers continues to grow worldwide, and a new study found that while teen boys have a greater risk for e-cigarette use, risk among teen girls is increasing more rapidly in recent years in Ireland.

“There has been a marked increase in teenage e-cigarette use in Ireland, [with] ever use up by 70% and current use up by 80%. Increases were more in boys than girls but increasing at a faster rate in girls,” Joan Hanafin, PhD, director of social research at the Tobacco Free Research Institute, Dublin, told Healio. “These gender differences suggest the need for tailored interventions.”

The researchers analyzed data from two Irish waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD). The cohort included 3,421 adolescents aged 16 years from 50 schools. These schools had 1,472 students, who were born in 1999, in 2015 and 1,949 students, who were born in 2003, in 2019. Researchers assessed e-cigarette use trends with e-cigarette ever use and current use as dependent variables.

“Our research had recently shown an increase in teenage smoking, particularly in boys. This increase occurred in tandem with the marked increase in teenage e-cigarette use during the same period, also particularly in boys. We wanted to explore ways in which gender was associated with these increases,” Hanafin told Healio.

From 2015 to 2019, e-cigarette ever use increased from 23% to 39%. During the same period, current use of e-cigarettes increased from 10% to 18%.

The researchers reported a greater rate of increase among teen girls (adjusted OR = 2.67; 95% CI, 2.02-3.54) compared with teen boys (aOR = 2.04; 95% CI, 1.55-2.68).

Adolescent peer smoking was significantly associated with e-cigarette ever use and current use, with the strongest association observed among boys (aOR = 5.9; 95% CI, 3.31-10.52) compared with girls (aOR = 3.5; 95% CI, 1.79-6.84). The researchers also reported an association between less parental monitoring and greater e-cigarette use, specifically for boys (aOR = 5.5; 95% CI, 2.85-10.61) compared with girls (aOR = 5.31; 95% CI, 3.01-9.37).

“Peer and family influences were prominent risk factors, more for boys than for girls,” Hanafin told Healio.

The researchers said further research is warranted.

“We urgently need to know why these increases in teenage e-cigarette use are happening,” Hanafin said. “Obviously, access, price and regulation are important drivers, but we suspect that the use of novel tobacco products is being promoted on social media platforms through individualized and gendered targeting of children and teenagers, and we plan to explore this through social media research and analysis.”