Sociodemographic Patterns of Exclusive and Dual Use of ENDS and Menthol/Non-Menthol Cigarettes among US Youth (Ages 15–17) Using Two Nationally Representative Surveys (2013–2017)

Abstract

The use of electronic nicotine delivery systems (ENDS) among youth in the United States has increased rapidly in the past decade. Simultaneously, while youth cigarette smoking has declined considerably, youth are still more likely to use menthol cigarettes than any other age group. We used nationally representative data on 15–17-year-olds from the Population Assessment of Tobacco and Health (PATH) Study and the National Youth Tobacco Survey (NYTS) (2013–2017) to better understand current cigarette (by menthol flavoring) and ENDS use in the US. We calculated weighted population prevalence estimates across years for multiple patterns of current cigarette and ENDS use (i.e., exclusive menthol cigarette, exclusive non-menthol cigarette, exclusive ENDS, dual ENDS and menthol cigarette, and dual ENDS and non-menthol cigarette) by sex, race/ethnicity, parental education level, household income, and homeownership. Overall, both exclusive menthol and non-menthol cigarette use declined from 2013–2017. Exclusive ENDS use increased, particularly among youth who were non-Hispanic White or had a higher socioeconomic status (measured by parental education, household income, and homeownership). Dual use of ENDS with either menthol or non-menthol cigarettes did not change significantly. Monitoring changes in these sociodemographic patterns will help inform future youth tobacco prevention strategies.

Sociodemographic Patterns of Exclusive and Dual Combustible Tobacco and E-Cigarette Use among US Adolescents—A Nationally Representative Study (2017–2020)

“…Regarding race/ethnicity, relative to NHW respondents, racial/ethnic minority respondents had lower odds of exclusive e-cigarette and dual use across all grades, which is consistent with previous research [ 2 , 4 , 12 ]. Also, as earlier studies show [ 12 , 13 ], we found that adolescents whose highest parental education was a college degree or more versus less than a high school degree had lower odds of exclusive combustible tobacco product and dual use when compared to no use, but higher odds of exclusive e-cigarette use.…”

“…Studies have shown slight sociodemographic differences among adolescents who exclusively use e-cigarettes versus combustible tobacco products. While male adolescents are more likely than females to use e-cigarettes exclusively [ 12 , 13 ], studies have shown comparable rates of exclusive combustible tobacco product use among males and females [ 4 , 12 ]. Unlike exclusive e-cigarette use, which is more common among non-Hispanic White adolescents compared to racial/ethnic minority adolescents, non-Hispanic Black adolescents are more likely to use combustible tobacco [ 2 , 4 ] when compared to non-Hispanic White adolescents.…”

“…Adolescents who use e-cigarettes exclusively are also more likely to have a higher socioeconomic status (SES), while adolescents who exclusively use combustible tobacco products are more likely to have a lower SES. On the other hand, there are sociodemographic similarities among adolescents who use e-cigarettes exclusively and those who use e-cigarettes and combustible tobacco products (dual use) [ 12 , 13 ]. These adolescents are more likely to be male than female, non-Hispanic White than a racial/ethnic minority, and have more highly-educated parents than less-educated parents [ 12 , 13 ].…”

“…On the other hand, there are sociodemographic similarities among adolescents who use e-cigarettes exclusively and those who use e-cigarettes and combustible tobacco products (dual use) [ 12 , 13 ]. These adolescents are more likely to be male than female, non-Hispanic White than a racial/ethnic minority, and have more highly-educated parents than less-educated parents [ 12 , 13 ].…”

Exclusive and dual menthol/non-menthol cigarette use with ENDS among adults, 2013–2019

“…However, including PATH in our study ensures comparability with earlier studies. ( Hirschtick et al, 2021 , Patel et al, 2021 , Villanti et al, 2017 ) Second, our current use measure did not distinguish between every day and some day users, even though product use and patterns of use may differ between both groups. However, our estimates are easily compared to other studies using this current use definition[51].…”