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Research

Reported electronic cigarette use among adolescents in the Niagara region of Ontario

Michael Khoury, Cedric Manlhiot, Chun-Po Steve Fan, Don Gibson, Karen Stearne, Nita Chahal, Stafford Dobbin and Brian W. McCrindle
CMAJ August 09, 2016 188 (11) 794-800; DOI: https://doi.org/10.1503/cmaj.151169
Michael Khoury
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Cedric Manlhiot
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Chun-Po Steve Fan
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Don Gibson
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Karen Stearne
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Nita Chahal
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Stafford Dobbin
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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Brian W. McCrindle
Department of Pediatrics (Khoury, Manlhiot, Fan, Chahal, McCrindle), Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ont.; Heart Niagara Inc. (Gibson, Stearne, Dobbin), Niagara Falls, Ont.
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  • For correspondence: brian.mccrindle@sickkids.ca
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    Figure 1:

    Motivating factors for using e-cigarettes among study respondents (n = 238).

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    Figure 2:

    Characteristics of respondents, by use of e-cigarettes. Note: Total no. of respondents who had used e-cigarettes: Sex, n = 238; Family member smokes, n = 236; Friends smoke, n = 236; Used cigarettes in last 30 d, n = 234; Cigarillo use, n = 236; Water pipe use, n = 234. Total no. of respondents who had not used e-cigarettes: Sex, n = 2040; Family member smokes, n = 2005; Friends smoke, n = 1999; Used cigarettes in last 30 d, n = 2021; Cigarillo use, n = 2034; Water pipe use, n = 2025.

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    Table 1:

    Characteristics of respondents in the Niagara region by population, e-cigarette use, cigarette use and use of other tobacco products

    CharacteristicNo. (%) of respondents
    n = 3312*
    Percentage of total
    Population
    Answered at least 1 question in the smoking section of the survey2367 (71.5)
    Male (n = 2367)1274 (53.8)
    E-cigarette use
    Heard of e-cigarettes (n = 2292)1599 (69.8)
    How students learned about e-cigarettes (n = 1599)
     Friends485 (30.3)
     Store sign/display380 (23.8)
     Internet186 (11.6)
     Other529 (33.1)
     No answer19 (1.2)
    Had used e-cigarettes (n = 2278)238 (10.4)
    Quantity of e-cigarette use (n = 238)
     Once134 (56.3)5.8†
     A few times79 (33.2)3†
     Frequently13 (5.5)0.6†
     Daily5 (2.1)0.2†
     No answer7 (2.9)0.3†
    Cigarette use
    Currently smoke (n = 2344)61 (2.6)
    Had smoked cigarettes during the last 30 d (n = 2302)66 (2.9)
    Frequency of smoking during the last 30 d (n = 66)
     1–2 d25 (37.9)1.0‡
     Some days17 (25.8)1.0‡
     Every day or almost every day24 (36.4)1.0‡
    Quantity of cigarettes smoked during the last 30 d (n = 66)
     ≤ 1 per d35 (53.0)1.5‡
     2–5 per d14 (21.2)0.6‡
     > 5 per d7 (10.6)0.3‡
     No response10 (15.1)0.4‡
    Type of smoker (self-defined) (n = 2205)
     Nonsmoker2128 (96.5)
     Nonsmoker who sometimes smokes32 (1.5)
     Former smoker, quit completely11 (0.5)
     Light smoker14 (0.6)
     Moderate/heavy smoker20 (0.9)
    Other tobacco products
    Had smoked cigarillos (n = 2297)84 (3.7)
    Had used smokeless tobacco (n = 2291)33 (1.4)
    Had smoked using a water pipe (n = 2288)57 (2.5)
    • Note: e-cigarette = electronic cigarette.

    • ↵* Unless otherwise indicated.

    • ↵† Distribution of frequency of e-cigarette use among all respondents to the e-cigarette questionnaire (n = 2278).

    • ↵‡ Distribution of smoking frequency and quantity during the last 30 d among all respondents to the smoking section of the questionnaire (n = 2302).

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    Table 2:

    Odds ratios calculated using multivariable logistic regression* for the association between e-cigarette use and sociodemographic factors, by risk factor

    Risk factorOR (95% CI)p
    Male1.7 (1.2–2.3)0.002
    Respondent knew that smoking can cause lung cancer0.2 (0.02–1)0.05
    Respondent had family members who smoke tobacco1.7 (1.2–2.4)0.003
    Respondent had friends who smoke tobacco3.6 (2.6–4.9)< 0.001
    Respondent currently smoked tobacco12.1 (6.6–22.4)< 0.001
    Smoking allowed inside respondent’s home1.8 (1.2–2.7)0.007
    Respondent reported excellent or good stress level0.6 (0.4–0.9)0.003
    • Note: CI = confidence interval, e-cigarette = electronic cigarette, OR = odds ratio. OR > 1 suggests a positive association between e-cigarette use and risk factor.

    • ↵* With multiple imputation of missing data.

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Canadian Medical Association Journal: 188 (11)
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9 Aug 2016
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Reported electronic cigarette use among adolescents in the Niagara region of Ontario
Michael Khoury, Cedric Manlhiot, Chun-Po Steve Fan, Don Gibson, Karen Stearne, Nita Chahal, Stafford Dobbin, Brian W. McCrindle
CMAJ Aug 2016, 188 (11) 794-800; DOI: 10.1503/cmaj.151169

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Reported electronic cigarette use among adolescents in the Niagara region of Ontario
Michael Khoury, Cedric Manlhiot, Chun-Po Steve Fan, Don Gibson, Karen Stearne, Nita Chahal, Stafford Dobbin, Brian W. McCrindle
CMAJ Aug 2016, 188 (11) 794-800; DOI: 10.1503/cmaj.151169
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