Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. Methods: A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. Results: Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. Conclusion: Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings.

The study adopted a mixed-method research approach. The population size of this study constitutes the last batch of Diploma in Basic Education (DBE) and the current first-year students of the new programme (Bachelor in Basic Education) of Mount Mary College of Education. Purposive and random sampling techniques were used to select seven hundred and seventy-nine (779) respondents for the study. A purposive sampling technique was used to select final year Diploma in Basic Education (DBE), made up of 312 and first-batch first-year students of the new programme (Bachelor in Basic Education) of Mount Mary College of Education, made of up 467 were used for data collection. A simple random technique was used to select 15 long essays from the final year Diploma in Basic Education while 30 assignments were selected from the first batch Bachelor in Basic Education students. Documents and interview guides were used for data collection. With an interpretative lens, the data were analysed in themes. The challenges in writing are the substitution of one modal verb for another, forceful insertions of modal verbs and improper modal forms. There was also proof that students were found to have used modal verbs in sentences that lacked the corresponding relationship with other clausal elements, making such constructions grammatically and pragmatically non-harmonious. It is recommended that there is a need to have a run-on design of the curricula by making sure that, a gradual introduction of modal verbs begins from the basic and low-grade level of the educational system to the highest. As these learners move up, they will correctly apply the verbs, changing from the core meaning of the modals to more complex uses. This concerted effort though will not be a panacea to the modal verbs challenge; it could mitigate he problem to a large extent.