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).

Akash Patel,Steven Cook,David T Levy,Nancy L Fleischer,Bukola Usidame,Ritesh Mistry,Rafael Meza,Jana L Hirschtick

doi:10.3390/ijerph18157781

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.

Highlights

IntroductionOver the past 20 years, there has been a continued reduction in cigarette smoking among middle and high school-aged youth (9–19 years) in the United States [1,2,3]
Using two nationally representative surveys with different modes of administration from 2013 to 2017, we examined the overall trends of exclusive menthol cigarette use, exclusive non-menthol cigarette use, exclusive electronic nicotine delivery systems (ENDS) use, dual use of ENDS and menthol cigarettes, and dual-use of ENDS and non-menthol cigarettes among adolescents aged 15–17
The Population Assessment of Tobacco and Health (PATH) Study is a collaboration between the National Institutes of Health, through the National Institute on Drug Abuse (NIDA), and the Food and Drug Administration (FDA)’s Center for Tobacco Products [54,55]

Summary

Introduction

Over the past 20 years, there has been a continued reduction in cigarette smoking among middle and high school-aged youth (9–19 years) in the United States [1,2,3]. A gradual decline in youth non-menthol cigarette use occurred from 2004 to 2010, but the prevalence of menthol cigarette use remained relatively stable during the same period [4,5,6,7]. In 2009, the US Food and Drug Administration (FDA) gained the authority to regulate the manufacturing, distribution, and marketing of tobacco products when the Family Smoking. Prevention and Tobacco Control Act was signed into law [8]. The law prohibited the sale of flavored cigarettes, excluding menthol and tobacco, restricted tobacco advertising that was considered attractive to youth

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