Objective  To investigate current status of lifestyle and e-health literacy and to explore the association of e-health literacy and lifestyle among 18 – 59 years old residents in Taian city of Shandong province.

  Methods   Using stratified multistage random cluster sampling, we recruited 4 580 residents aged 18 – 59 years in 6 districts/counties of Taian city, Shandong province and conducted face-to-face interviews with eHealth Literacy Scale – Chinese Version during August, 2020.

  Results  For all the participants, the e-health literacy score was 22.55 ± 12.69; the self-reported prevalence rates were 12.10% for smoking, 17.29% for alcohol drinking, 12.29% for not eating vegetables/fruits frequently, and 53.10% for inadequate physical activity, respectively. Unconditional multivariate logistic regression analysis demonstrated that a one point increment in the score of e-health literacy could be associated with 1.5% decrease in smoking prevalence (odds ratio OR = 0.985, 95% confidence interval 95% CI: 0.975 – 0.995), 1.9% increase in the prevalence of eating vegetables/fruits frequently (OR = 1.019, 95% CI: 1.010 – 1.029), and 2.3% increase in the prevalence of adequate physical activity (OR = 1.023, 95% CI: 1.017 – 1.030).

  Conclusion  Higher e-health literacy may associate with decreased smoking and increased healthy dietary behavior and physical activity among 18 – 59 years old community residents.