Abstract：Objective To investigate the e-cigarette use and its influencing factors among middle school students in Ningbo City, Zhejiang Province, so as to provide insights into e-cigarette control among adolescents. Methods Students of junior high schools, high schools and vocational high schools in Ningbo City were sampled using a multi-stage stratified cluster random sampling method from September to October 2021. Students' general information, cigarette and e-cigarette use and e-cigarette advertising exposure were collected using 2021 China Youth Tobacco Survey Questionnaire, and proportions of e-cigarette current use and attempt to use were analyzed. Factors affecting the attempt to use e-cigarettes were identified using a multivariable logistic regression model. Results Totally 1 591 questionnaires were allocated, and 1 574 valid questionnaires were recovered, with an effective rate of 98.93%. The respondents included 863 males (54.83%) and 711 females (45.17%); 787 junior high school students (50.00%), 535 high school students (33.99%) and 252 vocational high school students (16.01%). The proportion of current e-cigarette use was 1.91% and the proportion of attempt to use e-cigarettes was 6.61%. Multivariable logistic regression analysis identified males (OR=2.544, 95%CI: 1.438-4.501), living in rural areas (OR=2.084, 95%CI: 1.195-3.634), having close friends who were smokers (OR=4.828, 95%CI: 2.936-7.940), witnessing teachers smoking at school (OR=2.766, 95%CI: 1.642-4.659), e-cigarette advertising exposure (OR=2.155, 95%CI: 1.315-3.532), current cigarette use (OR=9.365, 95%CI: 2.610-33.603) and attempt to use cigarettes (OR=7.519, 95%CI: 4.115-13.737) as promoting factors for the attempt to use e-cigarette. Conclusions There are e-cigarette use behaviors among middle school students in Ningbo City. Having teachers or close friends who were smokers, cigarette use behaviors and e-cigarette advertising exposure may increase the risk of attempt to use e-cigarettes among middle school students.
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