E-cigarette use among adolescents in Latin America: A systematic review of prevalence and associated factors

Abstract

Background: 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.

Objective: To describe the prevalence and factors associated with e-cigarette use among adolescents in Latin America.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Adolescents; Associated factors; E-cigarettes; Latin America; Use.

Fig. 1

PRISMA flowchart illustrating the study selection process for this systematic review, detailing the number of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.

Fig. 2

Prevalence of e-cigarette use among adolescents in six Latin American countries, based on studies published between 2016 and 2024 (systematic review conducted in 2024). Error bars indicate the minimum and maximum prevalence reported in studies for each country.