E-cigarette use among adolescents in Latin America: A systematic review of prevalence and associated factors
Juan S. Izquierdo‐Condoy, Kenny Ruiz Sosa, Camila Salazar-Santoliva, Natalia Restrepo, Guillermo Olaya-Villareal, Juan S Castillo-Concha, Valentina Loaiza-Guevara, Esteban Ortiz‐Prado
Abstract
Electronic cigarettes, introduced as a safer tobacco alternative, have unintentionally exposed millions of youths to nicotine and harmful chemicals. Adolescence, a key period for forming lifelong habits, has seen rising e-cigarette use, particularly in developing regions like Latin America, warranting thorough investigation. To describe the prevalence and factors associated with e-cigarette use among adolescents in Latin America. A systematic review was conducted according to PRISMA guidelines, covering studies published between 2003 and May 2024. Database searches included PubMed/Medline, Web of Science, Scopus, Google Scholar, Scielo, and LILACS. A total of 582 studies were identified, of which 14 met the inclusion criteria. Study data were synthesized and assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklist. The prevalence of e-cigarette among adolescents in six Latin American countries ranged from 2.6 % to 64.2 %, with a pooled mean prevalence of 18.9 %, and lifetime use higher than current use. Key associated factors included male sex, concurrent use of tobacco and other substances, social influences, and exposure to online advertising. A widespread lack of knowledge regarding e-cigarette risks, coupled with limited regulatory oversight, may be contributing to higher usage rates. This review underscores critical gaps in data on adolescent e-cigarette use in Latin America and highlights the need for expanded research and targeted public health interventions. Nearly one-fifth of adolescents reported using e-cigarettes. Comprehensive prevention programs addressing factors associated with adolescent e-cigarette use in Latin America, involving diverse stakeholders and integrating education, school-based policies, social media campaigns, and policy restrictions, are strongly recommended. • E-cigarette use among Latin American adolescents ranges from 2.4 % to 64.2 %, with a pooled mean prevalence of 18.9 %. • Tobacco, substance use, and online ads are key factors linked to e-cigarette use in adolescents. • Knowledge gaps exist: 6 %–86 % of adolescents are unaware of e-cigarette risks. • Limited research exists in key countries, such as Brazil, Peru, Chile, and Uruguay. • Targeted prevention programs and stricter regulations are urgently needed.