Sexual Minority Youth E-Cigarette Use

Abstract

BACKGROUND AND OBJECTIVES: There is consistent evidence that sexual minority youth (SMY) use more traditional cigarettes than their non-SMY counterparts. However, there is relatively less information on e-cigarettes and, importantly, differences between and within SMY populations by race and ethnicity and sex. This study examines e-cigarette use by sexual orientation status and the intersection of race and ethnicity and sex. METHODS: Data come from high school students in the 2020 and 2021 National Youth Tobacco Surveys (N = 16 633). Current e-cigarette use prevalence by sexual identity categories was calculated for racial and ethnic subgroups. Multivariable logistic regression analysis examined the association between sexual identity and e-cigarette use by race and ethnicity groups and sex. RESULTS: E-cigarette use prevalence was higher for most SMY racial and ethnic groups than their non-SMY counterparts. However, multivariable logistic analysis showed varied results by race and ethnic groups, with higher e-cigarette use odds for SMY populations, although not statistically significant for some race and ethnic groups. Black gay or lesbian (adjusted odds ratio: 3.86, 95% confidence interval, 1.61–9.24) and bisexual (adjusted odds ratio: 3.31, 95% confidence interval, 1.32–8.30) high school students had significantly higher e-cigarette use odds than Black heterosexuals. Non-Hispanic Black females e-cigarettes use odds are 0.45 times that of non-Hispanic white males, and non-Hispanic other gay or lesbian had 3.15 times higher e-cigarette use odds than non-Hispanic white heterosexuals. CONCLUSIONS: E-cigarette use is more prevalent among SMY populations. Disparities in e-cigarette use vary depending on race and ethnicity and sex.

e-Cigarette Tobacco Flavors, Public Health, and Toxicity: Narrative Review

“…Dual users usually only use e-cigarettes when they are engaging in activities or in places that encourage e-cigarette use, or when they use e-cigarettes as substitutes for traditional cigarettes [ 47 ]. This type of difference becomes exceedingly important when there is a relatively high prevalence of vaping in the community (including minority youth) or when the community is our major target of protection (including age groups such as adolescents) [ 48 ]. For instance, among young adult e-cigarette users, bisexual women were the most susceptible to e-cigarette use habits with a high level of cigarette use [ 49 ].…”

Electronic Nicotine Delivery Systems (ENDS), Marginalized Populations, and Tobacco Regulatory Policies

“…African American gay or lesbian (OR: 3.86) and bisexual (OR: 3.31) high school students had significantly higher e-cigarette use odds than African American heterosexuals. Non-Hispanic African American females e-cigarettes use odds are 0.45 times that of non-Hispanic White males, and non-Hispanic other gay or lesbian had 3.15 times higher e-cigarette use odds than non-Hispanic white heterosexuals 37 .…”

“…Fourth, there are considerable disparities in e-cigarette use of lesbian, gay, bisexual, or transgender (LGBT) people, particularly those who are at the same time racial and ethnic minority 37 . In a study, e-cigarette use prevalence was higher for most non-heterosexual youths from racial and ethnic minority backgrounds than their heterosexual counterparts.…”

ENDS Tobacco Flavors, Public Health, and Toxicity

“…[3] This difference gets exceedingly important when there is a relatively high prevalence of vaping in the community (including sexual minority youth) or when the community is our major target of protection (including age groups like adolescents). [39] Despite the importance of understanding the different effects that the flavor addition has on various communities, there is minimal data on this issue and the differential effects remain unknown to us. Further studies should be done on these specific communities for us to comprehensively understand how the new tobacco-flavored e-cigarettes impact the entire vaping population and establish regulations accordingly.…”