Objective To examine the knowledge and attitude about electronic cigarette (e-cigarette) among adolescent never smokers in Guangzhou city and to provide preliminary evidences for developing and adjusting tobacco control strategies under the challenge of new tobacco products.

Methods A questionnaire survey was conducted among 1 601 randomly selected adolescents who never smoked in Guangzhou city of Guangdong province from September 1st, 2017 to September 30th, 2018.

Results Of all the respondents, only 283 (17.68%) have never heard of e-cigarette and 261 (16.30%) acquired knowledge about e-cigarette by themselves; 395 (24.67%) reported ever e-cigarette users among their friends or relatives. Compared to those for e-cigarette, significantly higher proportions of the respondents reported the agreement with comprehensive smoking ban policies for regular cigarettes, such as prohibition of selling tobacco products to juveniles (98.56% vs. 92.44%), no-smoking in indoor public places (95.32% vs. 80.51%), and no-smoking in outdoor public waiting areas (91.94% vs. 73.39%) (P < 0.001 for all).

Conclusion The use of electronic cigarette use may be more prevalent than expected in Guangzhou city and compared to regular cigarettes, adolescent never smokers are more tolerant to use of electronic cigarettes.