Prevalence and patterns of e-cigarette use among school-aged adolescents in Peru, 2024

The rapid rise in e-cigarette use among adolescents has become a global public health concern. Although regional data from Latin America exist, Peru lacks national evidence. We aimed to estimate the prevalence, describe patterns and explore motivations for e-cigarette use among secondary school students. We conducted a secondary data analysis of the 2024 National survey on drug use in secondary school students of Peru. The survey was administered through questionnaires to 45345 students from grades 1–5 of secondary education in urban areas. Weighted prevalences of ever, past 12-month, current and dual use (concurrent use of e-cigarettes and conventional cigarettes) were estimated. Analyses were conducted by sex and sources of access and motivations for use were also assessed. We included 45089 adolescents. Girls initiated e-cigarette use earlier than boys [age 14.7 (SD=1.3) vs 15.0 (SD=1.4) years, p<0.001]. The prevalence of ever use was 16.0% (95% CI: 15.5–16.6), higher in girls than boys (17.1% vs 15.0%, p<0.001). Past 12-month use was 10.9% (95% CI: 10.5–11.3), mostly 1–5 days, while current use was 6.9% (95% CI: 6.6–7.3) with no sex differences. Dual use was reported by 5.1% in the past 12 months and 2.7% in the past 30 days, the latter more frequent in boys (p=0.005). Moreover, the proportion of adolescents reporting each outcome increased progressively from first to the fifth grade. The main sources of access were convenience stores (29.7%) and neighborhood shops (18.1%). The leading motivations for use were flavor (30.8%), curiosity (20.4%) and stress management (12.9%). Differences in motivations were evident by sex and type of school. E-cigarette use is common among Peruvian adolescents, with dual use suggesting early nicotine dependence. Easy retail access and appealing flavors highlight regulatory gaps. Longitudinal studies are needed to clarify use trajectories and incidence and to inform effective public health and regulatory policies.