A Systematic Review of Socio-ecological Factors Influencing Current E-cigarette Use Among Adolescents and Young Adults

Introduction: The use of e-cigarettes has increased considerably among young people. To successfully develop interventions to prevent e-cigarette use, influencing factors must be identified. This review determines individual, interpersonal, organizational/community, and society/policy factors affecting e-cigarette use among adolescents and young adults.

Methods: A literature search was performed using five electronic databases (PubMed, CINAHL, EMBASE, Cochrane, and PsycInfo) for articles published in the English language to March 2022. A total of 85 studies were selected out of 17,259 for a systematic review based on the PRISMA flow. The full protocol is available from PROSPERO (CRD42021254558).

Results: Factors related to e-cigarette use were identified and classified into four domains based on the socio-ecological model. The individual factors were classified into five factors: demographics, health-related behaviors, mental health, perception of e-cigarettes, and characteristics of e-cigarettes. The interpersonal factors were classified into two factors: friend characteristics, including friend's e-cigarette use or smoking, and family factors such as parental smoking and parental advice. The organizational and community factors were home, school, online community, and retail shop accessibility. The society and police factors were regulation, media, and residence area.

Conclusion: The findings indicate that multi-dimensional factors influence e-cigarette use among adolescents and young adults. Therefore, an approach that considers these factors is required to develop effective interventions for the prevention of e-cigarette use.