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We investigated favourable perceptions of electronic cigarettes (ECs) relative to cigarettes and their associations with EC use susceptibility in adolescents. Hong Kong Chinese Secondary 1-6 (U.S. grade 7-12) students ( n = 40,202) were surveyed in 2014/2015 on EC use, cigarette smoking, favourable perceptions of ECs relative to cigarettes, EC use susceptibility, family smoking, and socio-demographic characteristics. Cox regression yielded adjusted prevalence ratios (APRs) of EC use susceptibility in never users, excluding those unaware of ECs. In all students, 8.9% were ever EC users, 47.2% reported favourable perceptions of ECs relative to cigarettes, such as less likely to cause accidents (25.2%) and less harmful to users (24.5%), and 28.9% did not know ECs. Among never EC users who were aware of ECs ( n = 24,663), EC use susceptibility was associated with each of the favourable perceptions, especially greater attractiveness (APR 2.84, 95% CI 2.53-3.19), and better parental (2.75, 2.41-3.15) and school acceptability (2.56, 2.15-3.05). An increased number of favourable perceptions of ECs relative to cigarettes was associated more strongly with the susceptibility ( p for trend &lt; 0.001). Our findings inform strategies to reduce unwarranted favourable perceptions and prevent adolescent EC use.

international journal of environmental  research and public health/international journal of environmental research and public health

Favourable Perceptions of Electronic Cigarettes Relative to Cigarettes and the Associations with Susceptibility to Electronic Cigarette Use in Hong Kong Chinese Adolescents