Summary
Introduction:
This article compares past 30-day use of e-cigarettes for high school and middle school students in the 2014-2019 National Youth Tobacco Surveys (NYTS) by year and smoking status, overall and stratified by frequency of e-cigarette use. The study aimed to provide results that can be compared with previous reports and focused on cigarette smoking as the primary tobacco product of interest.
Key Points:
* The study used nationally representative, school-based cross-sectional surveys conducted among middle and high school students.
* The NYTS measured frequency of e-cigarette use with the question: 'During the past 30 days, on how many days did you use electronic cigarettes or e-cigarettes such as Blu, 21st Century Smoke, or NJOY?'
* The study found that past 30-day e-cigarette use prevalence increased significantly among high school students from 13.4% in 2014 to 20.8% in 2018, but did not change significantly among middle school students (3.9% in 2014 and 4.9% in 2018).
* In 2019, more than a quarter of high school students and more than one in 10 middle school students used e-cigarettes in the past month.
* From 2014 to 2018, past 30-day e-cigarette use prevalence varied significantly by smoking status among both high school and middle school students, with the highest prevalence among current smokers and the lowest among never smokers.
* Prevalence increased significantly for never smokers in each frequency group, while for former smokers, the increases were significant for moderate and frequent use only.
* The study also found that although the prevalence of frequent e-cigarette use among high school students has been highest among current smokers, the estimated absolute number of frequent e-cigarette users who are never or former smokers together surpassed the number of frequent e-cigarette users who are current smokers in 2018.
Main Message:
The study highlights the importance of understanding e-cigarette use not as a stand-alone product, but rather as part of a complex tobacco product landscape. While e-cigarette use increased overall between 2014 and 2018 for high school students, it did not for middle school students. The study also found that interventions intended to reduce e-cigarette use will probably need to distinctly target smokers and non-smokers, and that interventions need to consider which groups are most at risk, which requires consideration of both numbers of people and magnitudes of potential harm.
Citation
Tam J, Brouwer aF. Comparison of e-cigarette use prevalence and frequency by smoking status among youth in the United States, 2014-19. addiction (abingdon, England). 2021;116(9):2486-2497. doi:10.1111/add.15439
