knowledge and attitudes towards electronic cigarette use among high school students in wroclaw, poland

Background: electronic nicotine delivery systems (ends), commonly referred to as electronic cigarettes has gained popularity among adolescents despite these products containing harmful constituents. objectives: the aim of this study was to assess the level of knowledge and attitudes among high school students regarding the health risks associated with ends use.methods: a cross-sectional analytical study was conducted in june 2025 among 111 students aged 15–19 years from a technical secondary school in wrocław, poland. participants were recruited using a random class-based sampling approach, and data were collected by a structured, self-administered questionnaire. the instrument assessed domains related to knowledge and attitudes toward ends use. results: overall, 53.1% of respondents reported ever using ends, including 30.6% classified as current e-cigarette users. the majority (59.4%) initiated use between the ages of 12 and 15. current e-cigarette users were significantly more likely to perceive ends as less harmful than conventional cigarettes (or = 6.08; 95% ci: 2.47–14.96; p = 0.0005). awareness of potential health risks varied across domains: cancer risk was the most frequently recognized (86.5%), whereas awareness was lower for cardiovascular (51.4%), gastrointestinal (44.1%), and hormonal (40.5%) effects. metabolic risks, including diabetes (14.4%) and obesity (17.1%), were the least recognized. current users demonstrated lower awareness of atherosclerosis risk compared with non-users (or = 0.31; 95% ci: 0.10–0.99; p = 0.032).conclusion: more than half of surveyed adolescents reported prior ends use, with a substantial proportion identifying as current users. knowledge of health risks was uneven, with limited awareness of metabolic and vascular consequences. these findings suggest the need for targeted school-based educational interventions addressing the full spectrum of ends-related health risks.