Changes in E-cigarette Use, Cigarette Smoking, and Dual-Use Among the Youth (13-15 Years) in 10 Countries (2013-2019)-Analyses of Global Youth Tobacco Surveys

INTRODUCTION: The increasing use of e-cigarettes among the youth is a public health problem that needs surveillance. We report changes in e-cigarette use, cigarette smoking, and "dual use" among youth in 10 countries.

AIMS AND METHODS: Global Youth Tobacco Survey (GYTS)s from Georgia, Iraq, Italy, Latvia, Montenegro, Paraguay, Peru, Qatar, Romania, and San Marino were analyzed. Changes in prevalence of "awareness of e-cigarettes," "ever use" (even tried a few puffs) and "current use" (during last 30 days) of e-cigarettes and cigarette smoking, and "dual use" (both e-cigarette and cigarette smoking) between baseline (2013 and 2014) and most recent (2017-2019) surveys were estimated.

RESULTS: "Awareness of e-cigarettes" and "ever e-cigarette use" significantly increased (p  50% in most countries. During the most recent surveys, "current e-cigarette" use was > 10% in five countries Italy (18.3%) and Latvia (18.5%) being the highest. Cigarette smoking significantly declined in Italy, Latvia, Peru, and San Marino (p