FITeens Toolkit

66 danger, especially to children and young people, who not only inhale fumes released by these residues but may also ingest residues that get on their hands after touching the furniture. While other forms of inhaled tobacco have been present for decades, e-cigarettes usage has become more common since 2006 and 2007, when they were first sold in Europe and in the United States of America, respectively (Hsu et al., 2018). Although the debate on the balance of harms and benefits of e-cigarettes for established smokers is still ongoing, the toxicological profile and the impact of nicotine on the developing adolescent brain make their use among children and young people especially concerning (Green et al., 2018). Nevertheless, several surveys have shown an increase in e-cigarettes use among adolescents. For example, the USA-based National Youth Tobacco Surveys reported the increase of e-cigarette use among high-school students from 1.5% in 2011 to 20.8% in 2018 (Cullen et al., 2018). Furthermore, the study examining the latest state of e-cigarette use in youth in 17 European study sites found that compared to 2014, for the year 2019 the age-adjusted prevalence of e-cigarettes use more than doubled among young people in several European countries such as Georgia, Italy and Latvia (Tarasenko et al., 2022). There are several factors that influence adolescents’ use of tobacco , including the use of tobacco by peers or family members; lack of the involvement and support from parents; low levels of academic achievement; inadequate or low self-esteem; low socio-economic status; accessibility, availability, and price of tobacco products; and exposure to tobacco advertising. Preventive interventions, thus, need to focus on these factors (Thomas et al., 2016). For example, it has been found that 19% of 12 th graders smoked if no parent smoked and 32% smoked if a parent smoked. Furthermore, the extensive literature review on determinants of