| Summary: | <i>Background and objectives:</i> This study assesses electronic cigarette (e-cigarette) use and its relationship with smoking and alcohol and illicit drug consumption among Romanian university students. <i>Materials and methods:</i> A cross sectional study using anonymous questionnaire was performed in 2017 among 400 university students from Cluj-Napoca, Romania. <i>Results</i>: 95.5% of the participants had heard about e-cigarettes and 43.7% of these had tried e-cigarettes during their lifetime, while 8.9% declared using cigarettes in the previous month (one out of five students who had tried them during their lifetime). Half of the students had smoked during their lifetime and one third had smoked in the previous month. Eighty-five percent of participants had experimented alcohol intoxication during their lifetime and 45% had done so in the previous month, while illicit drug use during their lifetime and the previous month was 34% and 9.5%, respectively. The results of the linear regression analyses show a positive correlation between e-cigarette use, smoking, experimentation with alcohol intoxication, and the use of illicit drugs. <i>Conclusions</i>: Future studies as well as educational activities should address the complex relationship between e-cigarette and other substance use among Romanian youth.
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