Kontakt 2025, 27(2):158-163 | DOI: 10.32725/kont.2025.013
Determinants of use and perceived harm of combustible tobacco and electronic cigarettes among high school students in PragueSocial Sciences in Health - Original article
- 1 Charles University, First Faculty of Medicine and General University Hospital Prague, Department of Addictology, Prague, Czech Republic
- 2 Charles University, Faculty of Education, Department of Psychology, Prague, Czech Republic
Background: The use of tobacco products and electronic cigarettes is a growing public health concern, especially among children and adolescents. Understanding the factors that impact both the use, and the perception of the harm related to these products is essential for developing effective prevention strategies targeting young people.
Objective: The aim of this study is to map the use of cigarettes and electronic cigarettes as well as the perceived risk of these products in a population of students from selected secondary schools in Prague. The partial aim was to determine whether the perceived harmfulness of the product, type of school, and gender play any role in the use of e-cigarettes or tobacco.
Methods: We conducted a questionnaire survey in secondary schools in the Capital City of Prague in cooperation with prevention methodologists. Data were collected in the first years of vocational and general secondary schools from students with an average age of 15 years.
Results and conclusion: The difference in frequency of tobacco product use between girls and boys was statistically insignificant, whereas the difference in tobacco product use between students at secondary schools providing general education and vocational education was found to be statistically significant. Perceived harmfulness of combustible cigarettes was significantly affected by the type of school. Regarding electronic cigarettes, the perceived harmfulness was significantly affected by both the type of school and gender. For electronic cigarettes and regular cigarettes, perceived harmfulness and school type appeared to be the predictors of use. Regarding electronic cigarettes, school type, perceived risk of the product, and gender were the predictors of use.
Keywords: Adolescents; Combustible cigarette; Electronic cigarette; Risk behaviour; Smoking; Tobacco
Grants and funding:
This paper was supported by the Cooperatio Programme of the Charles University, research area MCOM and Cooperatio [HEAS].
Conflicts of interest:
The authors have no conflict of interest to declare.
Received: November 21, 2024; Revised: February 18, 2025; Accepted: March 5, 2025; Prepublished online: March 11, 2025; Published: June 23, 2025 Show citation
ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
References
- . Barrington-Trimis JL, Urman R, Berhane K, Unger JB, Cruz TB, Pentz MA, et al. (2016). E-Cigarettes and Future Cigarette Use. Pediatrics 138(1): e20160379. DOI: 10.1542/peds.2016-0379.
Go to original source...
Go to PubMed...
- . Bast LS, Due P, Bendtsen P, Ringgard L, Wohllebe L, Damsgaard MT, et al. (2016). High impact of implementation on school-based smoking prevention: the X:IT study-a cluster-randomized smoking prevention trial. Implement Sci 11(1): 125. DOI: 10.1186/s13012-016-0490-7.
Go to original source...
Go to PubMed...
- . Campaign For Tobacco-Free kids (2024). Tobacco company marketing to kids. [online] [cit. 2024-11-12]. Available from: https://assets.tobaccofreekids.org/factsheets/0008.pdf
- . Ellickson PL, Bird CE, Orlando M, Klein DJ, McCaffrey DF (2003). Social Context and Adolescent Health Behavior: Does School-Level Smoking Prevalence Affect Students' Subsequent Smoking Behavior? J Health Soc Behav 44(4): 525-535. DOI: 10.2307/1519797.
Go to original source...
- . Gabrhelik R, Duncan A, Miovsky M, Furr-Holden CD, Stastna L, Jurystova L (2012). "Unplugged": a school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic. Drug Alcohol Depend 124(1-2): 79-87. DOI: 10.1016/j.drugalcdep.2011.12.010.
Go to original source...
Go to PubMed...
- . Gaiha SM, Lin C, Lempert LK, Halpern-Felsher B (2023). Use, marketing, and appeal of oral nicotine products among adolescents, young adults, and adults. Addict Behav 140: 107632. DOI: 10.1016/j.addbeh.2023.107632.
Go to original source...
Go to PubMed...
- . Green MJ, Gray L, Sweeting H, Benzeval M (2020). Socioeconomic patterning of vaping by smoking status among UK adults and Youth. BMC Public Health 20: 183. DOI: 10.1186/s12889-020-8270-3.
Go to original source...
Go to PubMed...
- . Hammond D, Reid JL, Burkhalter R, East K (2025). Use of disposable e-cigarettes among youth who vape in Canada, England and the United States: Repeat cross-sectional surveys, 2017-2023. Addiction 123(3): 405-413. DOI: 10.1111/add.16596.
Go to original source...
Go to PubMed...
- . Harvey J, Chadi N, Canadian Paediatric Society, Adolescent Health Committee (2016). Preventing smoking in children and adolescents: Recommendations for practice and policy. Paediatr Child Health 21(4): 209-214. DOI: 10.1093/pch/21.4.209.
Go to original source...
Go to PubMed...
- . Hejlová D, Schneiderová S, Klabíková Rábová T, Kulhánek A (2019). Analysis of Presumed IQOS Influencer Marketing on Instagram in the Czech Republic in 2018-2019. Adiktologie 19(1): 7-15.
Go to original source...
- . Hu MC, Griesler P, Schaffran C, Kandel D (2011). Risk and protective factors for nicotine dependence in adolescence: Factors for nicotine dependence. J Child Psychol Psychiatry 52(10): 1063-1072. DOI: 10.1111/j.1469-7610.2010.02362.x.
Go to original source...
Go to PubMed...
- . llésová L, Kulhánek A, Hejlová D (2023). "It looks like an accessory": Perception of heated tobacco products and its marketing communication among Generation Z. Adiktologie 23(2): 137-144. DOI: 10.35198/01-2023-001-0002.
Go to original source...
- . Kapan A, Stefanac S, Sandner I, Haider S, Grabovac I, Dorner TE (2020). Use of Electronic Cigarettes in European Populations: A Narrative Review. Int J Environ Res Public Health 17(6): 1971. DOI: 10.3390/ijerph17061971.
Go to original source...
Go to PubMed...
- . Kulhánek A, Baptistová A (2020). Chemical Composition of Electronic Cigarette E-Liquids: Overview of Current Evidence of Toxicity. Adiktologie 20(3-4): 137-144. DOI: 10.35198/01-2020-002-0007.
Go to original source...
- . Lapierre MA, Fleming-Milici F, Rozendaal E, McAlister AR, Castonguay J (2017). The Effect of Advertising on Children and Adolescents. Pediatrics 140(Suppl. 2): S152-S156. DOI: 10.1542/peds.2016-1758V.
Go to original source...
Go to PubMed...
- . Laverty AA, Vardavas CI, Filippidis FT (2021). Prevalence and reasons for use of Heated Tobacco Products (HTP) in Europe: an analysis of Eurobarometer data in 28 countries. Lancet Reg Health Eur 8: 100159. DOI: 10.1016/j.lanepe.2021.100159.
Go to original source...
Go to PubMed...
- . Leventhal AM, Goldenson NI, Cho J, Kirkpatrick MG, McConnell RS, Stone MD, et al. (2019). Flavored E-cigarette Use and Progression of Vaping in Adolescents. Pediatrics 144(5): e20190789. DOI: 10.1542/peds.2019-0789.
Go to original source...
Go to PubMed...
- . Lundborg P, Andersson H (2008). Gender, risk perceptions, and smoking behavior. J Health Econ 27(5): 1299-1311. DOI: 10.1016/j.jhealeco.2008.03.003.
Go to original source...
Go to PubMed...
- . Manzione LC, Shan L, Azagba S (2020). Associations Between Risk Perceptions and Cigarette, E-cigarette, and Dual-Product Use Among Canadian Adolescents. Tob Use Insights 4: 13:1179173X20903784. DOI: 10.1177/1179173X20903784.
Go to original source...
Go to PubMed...
- . Moor I, Rathmann K, Lenzi M, Pförtner TK, Nagelhout GE, de Looze M, et al. (2015). Socioeconomic inequalities in adolescent smoking across 35 countries: a multilevel analysis of the role of family, school and peers. Eur J Public Health 25(3): 457-463. DOI: 10.1093/eurpub/cku244.
Go to original source...
Go to PubMed...
- . O'Connor R, Schneller LM, Felicione NJ, Talhout R, Goniewicz ML, Ashley DL (2022). Evolution of tobacco products: recent history and future directions. Tob Control 31(2): 175-182. DOI: 10.1136/tobaccocontrol-2021-056544.
Go to original source...
Go to PubMed...
- . Oncken C, McKee S, Krishnan-Sarin S, O'Malley S, Mazure CM (2005). Knowledge and perceived risk of smoking-related conditions: A survey of cigarette smokers. Prev Med 40(6): 779-784. DOI: 10.1016/j.ypmed.2004.09.024.
Go to original source...
Go to PubMed...
- . Patiño-Masó J, Font-Mayolas S, Salamó A, Arboix M, Sullman MJ, Gras ME (2019). Predictors of intentions to use cigarettes and electronic cigarettes among high school students. J Multidiscip Healthc 12: 591-599. DOI: 10.2147/jmdh.s208031.
Go to original source...
Go to PubMed...
- . Pettigrew S, Alvin Santos J, Miller M, Sudhir Raj T, Jun M, Morelli G, Jones A (2023). E-cigarettes: A continuing public health challenge in India despite comprehensive bans. Prev Med Rep 31: 102108. DOI: 10.1016/j.pmedr.2022.102108.
Go to original source...
Go to PubMed...
- . Strong DR, Leas E, Elton-Marshall T, Wackowski OA, Travers M, Bansal-Travers M, et al. (2019). Harm perceptions and tobacco use initiation among youth in wave 1 and 2 of the population assessment of tobacco and Health (PATH) study. Prev Med 123: 185-191. DOI: 10.1016/j.ypmed.2019.03.017.
Go to original source...
Go to PubMed...
- . Thomas RE, McLellan J, Perera R (2013). School-based programmes for preventing smoking. Cochrane Database Syst Rev 2013(4): CD001293. DOI: 10.1002/14651858.CD001293.pub3.
Go to original source...
Go to PubMed...
- . Trucco EM, Fallah-Sohy N, Hartmann SA, Cristello JV (2020). Electronic Cigarette Use Among Youth: Understanding Unique Risks in a Vulnerable Population. Curr Addict Rep 7(4): 497-508. DOI: 10.1007/s40429-020-00340-w.
Go to original source...
Go to PubMed...
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.