Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta‐analysis of country level data

• Published in: Australian and New Zealand journal of public health Vol. 42; no. 3; pp. 303 - 308
• Main Authors: Yoong, Sze Lin, Stockings, Emily, Chai, Li Kheng, Tzelepis, Flora, Wiggers, John, Oldmeadow, Christopher, Paul, Christine, Peruga, Armando, Kingsland, Melanie, Attia, John, Wolfenden, Luke
• Format: Journal Article
• Language: English
• Published: Australia Elsevier B.V 01.06.2018; Elsevier Limited; Elsevier
• Subjects: Adolescent; Child; Confidence intervals; Data collection; Electronic cigarettes; electronic nicotine delivery systems; Electronic Nicotine Delivery Systems - statistics & numerical data; Endorsements; Estimates; Flammability; Global Health - statistics & numerical data; Health care policy; Health policy; Heterogeneity; Humans; Longitudinal studies; Meta-analysis; Nicotine; Polls & surveys; Population; Prevalence; Public health; Smoking; Smoking - epidemiology; Systematic review; Tobacco; Tobacco smoking; Young Adult; Youth; electronic nicotine delivery systems; youth; smoking
• ISSN: 1326-0200; 1753-6405
• DOI: 10.1111/1753-6405.12777

To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. Databases and the grey literature were systematically searched to December 2015. Studies describing the prevalence of ENDS use in the general population aged ≤20 years in a defined geographical region were included. Where multiple estimates were available within countries, prevalence estimates of ENDS use were pooled for each country separately. Data from 27 publications (36 surveys) from 13 countries were included. The prevalence of ENDS ever use in 2013–2015 among youth were highest in Poland (62.1%; 95%CI: 59.9–64.2%), and lowest in Italy (5.9%; 95%CI: 3.3–9.2%). Among non‐smoking youth, the prevalence of ENDS ever use in 2013–2015 varied, ranging from 4.2% (95%CI: 3.8–4.6%) in the US to 14.0% in New Zealand (95%CI: 12.7–15.4%). The prevalence of ENDS ever use among current tobacco smoking youth was the highest in Canada (71.9%, 95%CI: 70.9–72.8%) and lowest in Italy (29.9%, 95%CI: 18.5–42.5%). Between 2008 and 2015, ENDS ever use among youth increased in Poland, Korea, New Zealand and the US; decreased in Italy and Canada; and remained stable in the UK. There is considerable heterogeneity in ENDS use among youth globally across countries and also between current smokers and non‐smokers. Population‐level survey data on ENDS use is needed to inform public health policy and messaging globally.