A cross-sectional study was conducted in May 2013 in 6 high schools situated in 2 big cities from North-Western Romania −three high schools from Cluj-Napoca (a town with approximately 330,000 inhabitants) and three high schools from Sibiu (a town having approximately 147.000 inhabitants). The study was approved by the review committees of the management boards of the participating schools. From each high school there were randomly chosen 1-2 classes from 10th grade and 1-2 classes from 11th grade.

The students were informed that their participation in the study was voluntary and were asked to fill in an anonymous questionnaire. All students agreed to participate.

The questionnaire assessed socio-demographic characteristics, awareness and sources of information regarding electronic cigarettes. Opinions about e-cigarettes, their use during lifetime and in the last month, reasons for using them, intention to use them in the next year and experimentation with e-cigarettes by people from the social environment were also investigated. Smoking behaviour was also evaluated; persons who smoked traditional cigarettes in the last month were defined as smokers, those who smoked in the past but not in the last month were considered ex-smokers and students who never smoked traditional cigarettes were never-smokers. Number of cigarettes smoked per day and the intention to quit smoking in the future was also investigated among smokers.

Chi-square tests were used in order to compare smokers, ex-smokers and never-smokers with regard to the investigated issues.

Logistic regression analyses using the stepwise forward method were performed to assess the correlation of e-cigarettes experimentation and several variables among smokers (students who smoke in the last month) and non-smokers (comprised of ex-smokers and never smokers).

Data analysis was performed with the SPSS-20 statistics programme. Significant results are reported at p<0.05.

The study included 342 students aged 16-18 (mean age 17.02 years, SD=0.68) from the 10th and 11th grade (41.2% in the 10th grade and 48.8% in the 11th grade), living in two big cities of Romania (46.8% from Cluj-Napoca and 53.2% from Sibiu). Out of these, 46.5% were girls and 53.5% were boys.

The results showed that 37.4% of the students were smokers 19% were ex-smokers, while 43.6% were never-smokers.

Table 1 show that the majority of the students reported having heard about e-cigarettes. The main sources of information were friends (65.2%), internet (57.65%) and people from the same school year (39.7%); smokers were more interested to search information from these sources. One out of four students has got his information from the sale points, 14.6% from their parents and around 12% from school based health education lessons.

Half of the study sample believed that e-cigarettes were less dangerous than traditional cigarettes and considered that e-cigarettes could help in quitting smoking; 45% of the students have believed that e-cigarettes are only for smokers, with never-smoking students being statistically significant less convinced about this (Table 1).

The use of e-cigarettes perceived by students among their social environment was 67.1% among friends, 45.3% among people from the same school year, 7.3% among parents and 8.8% among their siblings.

52.3% of the smokers, 29.2% of the ex-smokers and 8.7% of the never-smokers declared that they had tried e-cigarettes at least once during their lifetime, while 7.8% of the smokers and 4.6% of the ex-smokers declared having used e-cigarettes in the last month. Intention to use them in the next year was declared by 32% of the smokers, 12.3% of the ex-smokers and 7.4% of the never-smokers.

Half of the smokers declared they used e-cigarettes because of curiosity, 21% because they are less dangerous than traditional cigarettes, while less than 20% used them to quit smoking or to reduce the number of cigarettes. Ex-smokers and never smokers tried e-cigarettes mainly because of curiosity and friend influences.

The results of the logistic regression analyses show that among smokers, e-cigarette experimentation was associated with lower participation in school health education regarding e-cigarettes and having parents using e-cigarettes. Among ex-smokers and never-smokers e-cigarettes experimentation was associated with intention to use e-cigarettes in the next year and with having friends using e-cigarettes (Table 2).