School-type differences in e-cigarette use and its correlates among Chinese adolescents

INTRODUCTION: Studies examining e-cigarette use among adolescents in Shanghai, China, have focused largely on middle school students. Given the vast differences between vocational and traditional schools, we aimed to explore school-type differences in e-cigarette use and correlates among adolescents in Shanghai. METHODS: The study was conducted in September 2017 through multistage and stratified cluster random sampling, which consisted of 10699 adolescents aged 13–17 years attending traditional and vocational schools in Shanghai. Descriptive statistics and multivariate logistic regressions were conducted to assess the weighted prevalence and correlates of ever e-cigarette use stratified by school type. RESULTS: The weighted prevalence of e-cigarette use was 5.21% among all respondents. Although e-cigarette use was more prevalent among students attending vocational schools (p<0.001), its correlates were similar across both school types. Among vocational school students, ever tobacco use (OR=3.10; 95% CI: 2.36–4.08) was the most significant correlate, followed by having most friends as smokers (OR=2.97; 95% CI: 1.84–4.81) and having morning cravings (OR=1.90; 95% CI: 1.64–2.20). Among traditional school students, having most friends as smokers (OR=4.87; 95% CI: 2.78–8.54) and ever tobacco use (OR=3.78; 95% CI: 2.68–5.34) were the most significant correlates, followed by knowledge of pro-tobacco advertisements (OR=2.12; 95% CI: 1.54–2.91). CONCLUSIONS: Joint efforts from the national, school and family levels are needed to control e-cigarette use among adolescents in China, and such efforts should be tailored to address differences in school characteristics.