Sociodemographic Correlates of Electronic Nicotine Delivery Systems (ENDS) Use in the United States, 2016-2017.

Introduction:
This article provides an analysis of the sociodemographic correlates of electronic nicotine delivery systems (ENDS) use in the United States from 2016-2017. The study aims to investigate ENDS use among priority populations and inform future studies and regulation. The study used data from two nationally representative surveys and examined the prevalence of ENDS awareness and use by combustible tobacco use status and sociodemographic variables relevant to tobacco disparities.

Key Points:

* The study found that overall, those younger than 60 years, people living at or above the poverty level, those with at least some college education, Whites, people with private or Veterans affairs, Department of Defense, or military health insurance, and those currently employed were more likely to be aware of ENDS.
* however, ENDS awareness was generally high across all sociodemographic groups.
* Different patterns emerged when stratifying by combustible tobacco use status. among former and current combustible tobacco users, those aged 18 to 29 years and sexual minorities were more likely to have used ENDS.
* among current cigarette smokers, those living in poverty were less likely to have used ENDS than were their counterparts living at or above the poverty line. however, among users of noncigarette combustible tobacco, individuals living in poverty were more likely to have used ENDS.
* among noncigarette combustible tobacco users, those with a high school education or less were more likely to have used ENDS than were those with at least some college education.
* Ever ENDS use by race/ethnicity differed in that Blacks were least likely to have used ENDS among former and current cigarettes smokers, but Whites were least likely to have used ENDS among those who currently used noncigarette combustible tobacco.
* Individuals without health insurance were most likely to have used ENDS only among current users of noncigarette combustible tobacco.

Main Message:
The study highlights the importance of considering multiple types of tobacco products to understand ENDS use among priority populations. The impact on tobacco disparities will ultimately depend on whether ENDS are used to transition completely away from combustible tobacco products and how this may differ across priority populations who use diverse tobacco products. The study also emphasizes the need to consider ENDS use by any combustible tobacco use status, rather than only cigarette smoking, and the importance of continued surveillance of ENDS use by sociodemographic variables, stratified by combustible tobacco use status, to understand whether ENDS increase or reduce the burden of tobacco for priority populations.

Spears Ca, Jones DM, Weaver SR, et al. Sociodemographic Correlates of Electronic Nicotine Delivery Systems (ENDS) Use in the United States, 2016-2017. american journal of public health. 2019;109(9):1224-1232. doi:10.2105/aJPh.2019.305158