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The objectives of the study were to assess awareness, opinions, and practices regarding electronic cigarette (e-cigarette) use, as well as factors associated with their use, among middle-school aged students from rural areas of Romania. The study sample included 748 middle-school students aged 13-14 years from 24 schools from rural areas situated in two counties from Romania, after receiving parental consent. A cross-sectional study using confidential questionnaires which assessed smoking-related behaviors, and also opinions and practic