Longitudinal analysis of predictors of electronic cigarette trial among adolescents in Guatemala.

Background: Understanding factors influencing electronic cigarette (e-cigarette) trial in adolescents is crucial for shaping policies and interventions to reduce consumption and potentially prevent addictive tendencies, particularly in countries with weak regulations like Guatemala.

Objective: We aimed to longitudinally assess predictors of e-cigarette trial among Guatemalan adolescents surveyed in 2019, 2020, and 2021.

Methods: Students (13 to 18 years old) from nine private schools completed self-administered questionnaires about e-cigarette use and associated risk factors. Data from those who had at least one follow-up survey after reporting that they had never tried e-cigarettes at either the 2019 or 2020 survey (N = 838) was analyzed. We used a mixed-effects logistic regression clustered by student and school to assess predictors of ever e-cigarette use.

Results: Nearly one-quarter (21.0 %) of unique students tried e-cigarettes at follow-up. Risk factors for e-cigarette trial included cigarette or heated tobacco products use (adjusted odds ratio [AOR] = 2.95, 95 %CI = 1.24-7.04), frequent exposure to online e-cigarette marketing (AOR = 2.46, 95 %CI = 1.39-4.35), alcohol or marihuana use (AOR = 1.74, 95 %CI = 1.17-2.58), and parental approval of e-cigarette use (AOR = 1.65, 95 %CI = 1.14-2.40). The perception that serious illness from life-long e-cigarette use is likely or certain (AOR = 0.57, 95 %CI = 0.36-0.91, and AOR = 0.37, 95 %CI = 0.19-0.72, respectively) appeared as a protective factor for e-cigarette trial.

Conclusion: Our findings align with international research, indicating shared risk factors across youth worldwide. The incorporation of these factors into policies and interventions targeting the reduction of e-cigarette trial is imperative for optimizing their efficacy.