OBJECTIVES: Adolescent e-cigarette use has increased worldwide, reflecting digital exposure and shifting norms. This study aimed to identify socioeconomic and digital determinants of e-cigarette use among adolescents and to inform prevention strategies. METHODS: Data were collected from April to July 2024 among 829 students aged 11 to 19 years in three schools in northern Germany. An age-adapted questionnaire co-developed with students assessed sociodemographic characteristics, parental and media influences, risk perception, and nicotine use. Descriptive statistics and logistic regression models were applied. RESULTS: Of all participants, 37.2% had tried e-cigarettes and 6.7% reported daily use. E-cigarette use increased with age (p < .01) but did not differ by gender. Exposure to e-cigarette content on TikTok (OR = 3.32, p < .01) and Instagram (OR = 3.00, p < .01) showed associations with e-cigarette use. Higher pocket money and parental nicotine consumption were associated with increased odds of e-cigarette use (OR = 3.00, p < .01; OR = 4.05, p < .01). Only 41% reported receiving school-based education on e-cigarette use. CONCLUSIONS: Adolescent e-cigarette use is shaped by digital exposure, socioeconomic resources, and parental behavior. Prevention requires regulation of advertising, integration into school curricula, and family-based communication.
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