Associations between trying to control weight, weight control behaviors and current electronic cigarette usage in middle and high school students: A cross-sectional study in Zhejiang Province, China.

Introduction: Previous research has indicated that weight control behaviors are linked to cigarette smoking, whether these relationships extend to electronic cigarettes (e-cigarettes) is unknown. This study aims to examine the association between weight control behaviors and current e-cigarette usage among middle and high school students in China.

Methods: Based on the 2017 Zhejiang Youth Risk Behavior Survey, 17359 students were included and relevant data involving e-cigarette and weight control behaviors were collected via self-reported questionnaires. Logistic regression models were used to examine the associations between trying to control weight, specific weight control behaviors and current e-cigarette usage. Odds ratios (ORs) and their 95% confidence intervals (CIs) are reported.

Results: Of the 17359 students, 374 (2.15%) were current e-cigarette users. No significant association was observed between trying to control weight and current e-cigarette usage (OR=1.01; 95% CI: 0.81-1.28). Significant associations were found between current e-cigarette usage and unhealthy weight control behaviors of eating less food, fewer calories (OR=1.74; 95% CI: 1.33-2.27), as well as taking laxatives (OR=3.34; 95% CI: 2.11-5.27), taking diet pills (OR=2.63; 95% CI: 1.72-4.02) and going without eating for 24 hours or more (OR=2.74; 95% CI: 1.86-4.04).

Conclusions: A positive association was found between unhealthy weight control behaviors and current e-cigarette usage in adolescents. Specific education programs on unhealthy weight control behaviors should be considered in adolescents.