Background:
Globally, evidence on the awareness and use of electronic cigarettes (e-cigarettes) is limited. We examined the awareness and current use of e-cigarettes among male and female students aged 13-15 years old across 16 countries or regions that conducted the Global Youth Tobacco Survey (GYTS).

Methods:
GYTS is a cross-sectional, nationally representative, school-based survey of students aged 13-15 years. Data from the16 countries or regions were used to examine student awareness (ever heard of) and current use (in the past 30 days) of e-cigarettes. Sample sizes across the 16 countries or regions ranged from 962 in Georgia to 5,153 in Paraguay and response rates ranged from 75.4% in Georgia to 99.2% in Sudan. Weighted point estimates and 95% confidence intervals (CI) were calculated and statistically significant differences (p< 0.05) by gender were assessed using a two-sample t-test.

Results:
Awareness of e-cigarettes ranged from 19.6% (95% CI: 16.1-23.6) in Peru to 93.0% (95% CI: 91.4-94.3) in the Moscow region of Russia. Across all sites, only Seychelles and United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) had significantly higher awareness of e-cigarette among boys than girls. Current use of e-cigarettes ranged from 1.6% (95% CI: 1.1-2.5) in Kazakhstan to 15.4% (95% CI: 12.6-18.5) in UNRWA. In Albania, Belize, Macao, Seychelles, and UNRWA, boys had a significantly higher prevalence of current e-cigarette use than girls.

Conclusions:
The findings show that awareness and use of e-cigarettes varies considerably across 16 countries/regions. GYTS is a viable platform to measure tobacco use among youth, including emerging products such as e-cigarettes.