Peer Influence and Use of Electronic Cigarettes among Adolescents and Young Adults: A Meta-Analysis of Prospective Studies.

OBJECTIVE

To examine the association between peer use and individual use of EC among adolescents and young adults.

METHODS

We performed the search strategy on PubMed, EMBASE, and Cochrane. We selected prospective studies reporting adjusted odds ratio (aOR)/relative risk (aRR) with a 95% confidence interval (CI) and conducted a random-effects meta-analysis.

RESULT

Eleven prospective studies were included, involving 32,014 participants in the quantitative analysis. Meta-analysis results showed a significant association between EC use by friends and increased odds of individual EC use (aOR = 1.79, 95% CI 1.43 to 2.25; I2 = 88.2% for ever use; aOR = 2.14, 95% CI 1.52 to 3.01; I2 = 88.5% for current use). In the subgroup meta-analysis of outcomes, having friends who used EC significantly increased the odds of ever- and current EC use. Similar findings were found in the subgroup meta-analyses by age group, region, sample size, study methodological quality, and follow-up time.

CONCLUSION

This study revealed a positive association between individual EC use and friends' use, especially among those under 18 years, suggesting targeting peer networks to curb the EC epidemic.