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.

Highlights

  • Morbidity and Mortality Weekly ReportRacial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students — United States, 2014–2017

  • Ever-use was highest for cigarettes among AI/AN students (31.4%), highest for cigars among black students (19.9%), and highest for e-cigarettes among all other racial/ethnic groups

  • Given that cigar smoking has historically been higher among black adults than other racial/ethnic groups [6,7], these findings suggest distinct acculturation and social norms regarding tobacco use across racial/ethnic groups

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Summary

Morbidity and Mortality Weekly Report

Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students — United States, 2014–2017. 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%). Pooled sample sizes for each racial/ethnic group during 2014–2017 included 32,358 whites, 11,664 blacks, 21,337 Hispanics, 3,321 Asians, 1,213 AI/ANs, 456 NHOPIs, and 4,106 multiracial persons. During 2014–2017, ever-use of any tobacco product among U.S middle and high school students was highest among NHOPIs (45.1%) and AI/ANs (43.8%), and did not significantly differ between these groups Compared with these two groups, prevalence of ever-use of any tobacco product was significantly lower among multiracial persons (38.2%), Hispanics (35.1%), blacks (32.3%), whites (32.0%), and Asians (16.3%) (Table 1).

Multiracial Overall Male Female MS HS
Current Use of Tobacco Products
Discussion
Findings
What is known about this topic?
What are the implications for public health practice?

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