Abstract
This study assessed the sociodemographic predictors of exclusive and dual use of the most frequently used nicotine/tobacco products, e-cigarettes, and combustible tobacco among adolescents. Cross-sectional data was from the 2017–2020 Monitoring the Future nationally representative study of eighth, tenth, and twelfth-grade students. We coded past 30 day nicotine/tobacco use into four mutually exclusive categories: no use, e-cigarette use only, combustible use (cigarette or cigar) only, and dual use (e-cigarette and combustible). We pooled the 2017–2020 data to examine the relationship between sex, race/ethnicity, parental education, and each product-use category using multinomial logistic regression, stratified by grade level. Among eighth (N = 11,189), tenth (N = 12,882), and twelfth graders (N = 11,385), exclusive e-cigarette use was the most prevalent pattern (6.4%, 13.2%, 13.8%, respectively), followed by dual use (2.7%, 4.5%, 8.9%), and exclusive combustible use (1.5%, 2.5%, 5.3%). eighth and tenth-grade adolescents whose highest parental education was a 4-year college degree or more had lower odds of exclusive combustible and dual use when compared to adolescents whose highest parental education was less than a high school degree. Research should continue to monitor the differential use of combustible tobacco products and e-cigarettes among adolescents from low socioeconomic status backgrounds or racial/ethnic minority households to inform ongoing and future interventions or policies.
Highlights
IntroductionTobacco or nicotine product use among adolescents is a major public health crisis in the United States, with the rapid increase in e-cigarette use in recent years [1–5]
Tobacco or nicotine product use among adolescents is a major public health crisis in the United States, with the rapid increase in e-cigarette use in recent years [1–5].E-cigarettes are the most commonly used nicotine products among adolescents, followed by cigarettes and cigars [4,6]
Tenth, and twelfth graders, past 30 day cigarette use ranged from 1.9% to 9.7%, past 30 day cigar use ranged from 1.3% to 10.1%, and past 30 day e-cigarette use ranged from 3.5% to 25.5% from 2017 to 2020 [6]
Summary
Tobacco or nicotine product use among adolescents is a major public health crisis in the United States, with the rapid increase in e-cigarette use in recent years [1–5]. E-cigarettes are the most commonly used nicotine products among adolescents, followed by cigarettes and cigars [4,6]. Dual use of any two nicotine/tobacco products ranged from 2.4% to 4.0% among middle school students and from 8.2% to 10.8% among high school students from 2017 to 2020, with cigarettes, cigars, and e-cigarettes being the most frequently combined products [2–4]. Research suggests that e-cigarette use may increase the risk of dual nicotine/tobacco use among adolescents [6], which has been linked with increased school- and substance-related risk behaviors [7,8]. E-cigarettes are currently the predominant nicotine product used by adolescents, studies have highlighted the need to continue to assess combustible products (cigarettes or cigars) use because of their health impacts. Individuals who use combustible tobacco products face health consequences such as cancers, though those who smoke cigars
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