@article {Khoury794, author = {Michael Khoury and Cedric Manlhiot and Chun-Po Steve Fan and Don Gibson and Karen Stearne and Nita Chahal and Stafford Dobbin and Brian W. McCrindle}, title = {Reported electronic cigarette use among adolescents in the Niagara region of Ontario}, volume = {188}, number = {11}, pages = {794--800}, year = {2016}, doi = {10.1503/cmaj.151169}, publisher = {CMAJ}, abstract = {Background: Use of electronic cigarettes (e-cigarettes) among adolescents has not been fully described, in particular their motivations for using them and factors associated with use. We sought to evaluate the frequency, motivations and associated factors for e-cigarette use among adolescents in Ontario.Methods: We conducted a cross-sectional study in the Niagara region of Ontario, Canada, involving universal screening of students enrolled in grade 9 in co-operation with the Heart Niagara Inc. Healthy Heart Schools{\textquoteright} Program (for the 2013{\textendash}2014 school year). We used a questionnaire to assess cigarette, e-cigarette and other tobacco use, and self-rated health and stress. We assessed household income using 2011 Canadian census data by matching postal codes to census code.Results: Of 3312 respondents, 2367 answered at least 1 question in the smoking section of the questionnaire (1274 of the 2367 respondents [53.8\%] were male, with a mean [SD] age of 14.6 [0.5] yr) and 2292 answered the question about use of e-cigarettes. Most respondents to the questions about use of e-cigarettes (n = 1599, 69.8\%) had heard of e-cigarettes, and 380 (23.8\%) of these respondents had learned about them from a store sign or display. Use of e-cigarettes was reported by 238 (10.4\%) students. Most of the respondents who reported using e-cigarettes (171, 71.9\%) tried them because it was {\textquotedblleft}cool/fun/new,{\textquotedblright} whereas 14 (5.8\%) reported using them for smoking reduction or cessation. Male sex, recent cigarette or other tobacco use, family members who smoke and friends who smoke were strongly associated with reported e-cigarette use. Reported use of e-cigarettes was associated with self-identified fair/poor health rating (odds ratio [OR] 1.9 (95\% confidence interval [CI] 1.2{\textendash}3.0), p \< 0.001), high stress level (OR 1.7 (95\% CI 1.1{\textendash}2.7), p \< 0.001) and lower mean (33.4 [8.4] {\texttimes} $1000 v. 36.1 [10.7] {\texttimes} $1000, p = 0.001) and median [interquartile range] (26.2 [5.6] {\texttimes} $1000 v. 28.1 [5.7] {\texttimes} $1000) household incomes.Interpretation: Use of e-cigarettes is common among adolescents in the Niagara region and is associated with sociodemographic features. Engaging in seemingly exciting new behaviours appears to be a key motivating factor rather than smoking cessation.See also page 785 and www.cmaj.ca/lookup/doi/10.1503/cmaj.160728}, issn = {0820-3946}, URL = {https://www.cmaj.ca/content/188/11/794}, eprint = {https://www.cmaj.ca/content/188/11/794.full.pdf}, journal = {CMAJ} }