Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students — United States, 2014–2017

Abstract

During the past few decades, wide disparities in tobacco product use have been documented among the largest racial/ethnic groups in the United States (1,2); however, little is known about tobacco product use among youths from racial/ethnic groups other than whites, blacks, and Hispanics. Surveillance reports typically aggregate these racial/ethnic minorities into a single category because of small sample sizes (3). To assess tobacco product use among U.S. middle and high school students from seven racial/ethnic groups (non-Hispanic whites [whites], non-Hispanic blacks [blacks], Hispanics, non-Hispanic Asians [Asians], non-Hispanic American Indian/Alaska natives [AI/ANs], non-Hispanic Native Hawaiians/Other Pacific Islanders [NHOPIs], and non-Hispanic multiracial persons [multiracial]), CDC analyzed pooled data from the 2014–2017 National Youth Tobacco Surveys (NYTS). Prevalence of ever (≥1 time in lifetime) and current (≥1 time in past 30 days) use of seven tobacco products (cigarettes, cigars, smokeless tobacco, electronic cigarettes [e-cigarettes], hookahs, pipes, and bidis) was assessed; any tobacco product use was defined as use of one or more tobacco products, including hand-rolled cigarettes. During 2014–2017, ever-use of any tobacco product among U.S. middle and high school students was as follows: NHOPIs (45.1%), AI/ANs (43.8%), multiracial persons (38.2%), Hispanics (35.1%), blacks (32.3%), whites (32.0%), and Asians (16.3%). Current use of any tobacco product was as follows: NHOPIs (23.4%), AI/ANs (20.6%), multiracial persons (16.5%), whites (15.3%), Hispanics (14.6%), blacks (11.5%), and Asians (5.0%). Among black middle and high school students, cigars were the most common product currently used, whereas e-cigarettes were the most commonly used product for all other racial/ethnic groups. Comprehensive and sustained implementation of evidence-based, population-level tobacco control interventions could reduce prevalence and disparities in tobacco product use among U.S. youths.

Age of initiation of cigarette smoking and smokeless tobacco use among western Alaska Native people: Secondary analysis of the WATCH study

“…Our study was limited to assessment of cigarettes, commercial ST, and iqmik . Non-cigarette tobacco products are evolving rapidly, with increasing popularity in the U.S. ( Kasza et al, 2017 ; Odani et al, 2018 ). However, minimal use of pipe or cigar smoking has been reported in these regions ( Renner et al, 2004 ), and data collection occurred prior to the outspread use of e-cigarettes.…”

“…Because each of the studies specified cigarette smoking (as opposed to cigar, pipe, or other tobacco types) and the exact amount (≥100 cigarettes in a lifetime), we were able to directly combine these study data without altering the definition and preserving data precision. Consistent with other surveys (e.g., Odani, Armour, & Agaku, 2018 ), we defined ever use of ST as self-reported use of any commercial or homemade ST products. ST data were harmonized to include both commercial and homemade ST products, which varied by communities and regions.…”

Characteristics and Reach Equity of Policies Restricting Flavored Tobacco Product Sales in the United States

“…Current FTP policies provided reach equity to vulnerable populations defined by education and income, young adults, women, and partnered same-sex households. They also provided equitable reach to many communities of color but notably lack equitable reach to AIAN and NHPI populations who have some of the greatest tobacco use disparities among racial/ethnic minority groups in the United States; for example, current tobacco use prevalence among NHPI (23.4%) and AIAN (20.6%) middle and high school students is higher than any other group (Odani, Armour, & Agaku, 2018). The population protected by any FTP policy included a larger proportion of African Americans than the national population but the population protected by strong FTP policies (which include restrictions on menthol cigarette sales) included a smaller proportion of African Americans than the national population.…”

Trends in Cigar Use in the United States, 2002–2016: Diverging Trends by Race/Ethnicity

“…NH Black adolescents report greater susceptibility to use cigars than do NH White and Hispanic adolescents, 15 and cigars are the most commonly reported tobacco product used by NH Black middle and high school students (vs. electronic cigarettes for other racial/ethnic groups). 16 In addition to targeting NH Black adults, especially women, to decrease the prevalence of cigar use, it may also be useful to target young cigar users and youth who may be susceptible to later cigar use. There are a number of limitations.…”