School-Level Prevalence and Predictors of e-Cigarette Use in 8th, 10th, and 12th Grade U.S. Youth: Results From a National Survey (2015-2016).

Introduction:
This text provides an analysis of the relationship between school characteristics and the use of electronic cigarettes (e-cigarettes) among US adolescents. The study uses data from the Monitoring the Future (MTF) survey, a nationally representative sample of 8th, 10th, and 12th graders, to examine school-level prevalence of e-cigarette use and identify risk factors associated with school-level characteristics.

Key Points:

* The study uses data from the MTF survey, which includes a nationally representative sample of 8th, 10th, and 12th graders in US schools.
* School-level prevalence of e-cigarette use varies considerably, ranging from 0% to 60%.
* Schools with a higher proportion of white students, located in the Southern and Western regions of the US, and with higher prevalence of past-month cigarette smoking have higher odds of e-cigarette use.
* Individual-level factors associated with e-cigarette use include being male, white, having poor grades, and using other substances such as alcohol, cigarettes, marijuana, and nonmedical prescription drugs.
* The study controls for student- and school-level covariates, including cohort year and grade-level of student, using design-based approaches and robust standard errors.
* Multivariable logistic regression models are used to estimate the association between past-month e-cigarette use and student- and school-level characteristics.
* The study finds that school-level e-cigarette use is not associated with individual-level cigarette smoking, but there are sex interactions that widen the risk for e-cigarette use between females and males at higher grade levels.

Main Message:
The study highlights the wide range in prevalence of e-cigarette use at US middle and high schools and the importance of school environments in influencing cigarette and e-cigarette use. The findings suggest that school context plays an important role in e-cigarette use, and schools are encouraged to assess their own student body to guide prevention efforts. The study also underscores the need for more longitudinal research on the impact of e-cigarette use on physical health, other drug use, and efficacy in smoking cessation.

McCabe SE, Boyd CJ, Evans-Polce RJ, McCabe VV, Veliz PT. School-Level Prevalence and Predictors of e-Cigarette Use in 8th, 10th, and 12th Grade U.S. Youth: Results From a National Survey (2015-2016). The Journal of adolescent health : official publication of the Society for adolescent Medicine. 2020;67(4):531-541. doi:10.1016/j.jadohealth.2020.03.032