Tobacco and vaping exposure among Spanish adolescents: An analysis of digital, social, school, and family environments
Abstract
Introduction: Involuntary exposure to secondhand tobacco smoke (SHS) and secondhand aerosol from electronic cigarettes (SHA) persists in homes, vehicles, educational settings, and recreational spaces, increasing adolescents' risk of respiratory infections, asthma, and impaired lung development1. The study aim was to examine among Spanish adolescents, aged 12-21 years, the associations between: 1) the presence of social models who smoke or vape (parents, siblings, peers, teachers); 2) self-perceived exposure to smoke or aerosol in physical environments (home, school, car, public spaces); 3) digital exposure to both anti-tobacco messaging and vaping-related content on social media and video platforms; and 4) age-based sales restrictions for nicotine products. We hypothesized that higher levels of physical or digital exposure and the presence of smoking or vaping role models would be associated with greater likelihood of trying conventional or electronic cigarettes.
Methods: We conducted a cross-sectional survey of 2823 students (mean age=13.8 ± 1.2 years; 49.2% female) in public and charter schools between 2021 and 2024. A validated questionnaire (Cronbach's α=0.72-0.84) assessed experimental tobacco and vaping use, social models, physical and digital exposures, and purchase attempts/denials. Analyses included bivariate tests (χ2, Cramér's V), logistic regression for tobacco experimentation and multiple linear regression for vaping.
Results: Among participants, 21% had tried…
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