Socioeconomic Differences in Lifetime and Past 30-Day E-Cigarette, Cigarette, and Dual Use: A State-Level Analysis of Utah Youth.

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Socioeconomic disparities in combustible cigarette use are well established among youth in the United States and lead to substantial health effects. Given the noteworthy rise in electronic cigarette (e-cigarette) use among youth in recent years, health professionals have expressed concern that e-cigarette use will follow similar socioeconomic patterns. The current study examined this question using a 2019 state-representative sample of youth in grades 6, 8, 10, and 12 from Utah (N = 78,740). Logistic regression models estimated associations between neighborhood- and individual-level factors with lifetime and past 30-day e-cigarette, combustible cigarette, and dual use across 267 neighborhoods. After controlling for individual-level sociodemographic factors, results indicated that youth living in higher-poverty neighborhoods were at a significantly increased risk of lifetime e-cigarette, combustible cigarette, and dual use. Additionally, youth living in households with higher levels of education were at a significantly lower risk of lifetime and past 30-day e-cigarette, cigarette, and dual use. Results suggest that e-cigarettes may follow a similar pattern of socioeconomic disparities among youth as combustible cigarettes. Additionally, most youth using combustible cigarettes also used e-cigarettes, suggesting that any potential harms from e-cigarettes may exacerbate existing socioeconomic disparities in health effects from combustible cigarette use. Research should continue to examine individual- and neighborhood-level socioeconomic disparities in youth e-cigarette, combustible cigarette, and dual use.