Trends of Single, Dual, and Polytobacco Use Among School-Based Students in the United States: An Analysis of the National Youth Tobacco Survey

• Published in: American journal of health promotion Vol. 37; no. 8; pp. 1078 - 1090
• Main Authors: Cook, Steven, Ortiz Chavez, Stephany, Zavala-Arciniega, Luis, Hirschtick, Jana L., Fleischer, Nancy L.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2023; American Journal of Health Promotion
• Subjects: Adolescent; Cigarettes; Cigars; Electronic cigarettes; Electronic Nicotine Delivery Systems; Ethnic groups; Ethnicity; Female; Health promotion; Humans; Male; Middle schools; Polls & surveys; Prevention programs; Race; Secondary schools; Sociodemographics; Students; Teenagers; Tobacco; Tobacco Products; Tobacco Use - epidemiology; Tobacco Use Disorder; Trends; United States - epidemiology; Youth; United States; United States > US; population health; health policy; school; adolescents; tobacco control
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/08901171231191557

Purpose To examine trends in single, dual, and polytobacco use between 2014-2020 for US youth and to identify disparities in these trends by grade level, sex, and race/ethnicity. Design A secondary analysis of the National Youth Tobacco Survey (NYTS). Subjects A total of 122 566 students. Measures Past 30-day exclusive use of cigarettes, e-cigarettes, other combustibles (cigars, little cigars, cigarillos, hookah, pipe tobacco, bidis) and smokeless tobacco (snus, smokeless, dissolvable); dual use of each product with e-cigarettes; polyuse with e-cigarettes; dual/polyuse without e-cigarettes. Analysis Multivariable modified Poisson regression. Results Compared to 2014, exclusive e-cigarette use (APR = 2.51, 95% CI: 1.96, 3.21) trended upward while exclusive cigarette (APR = .34, 95% CI: .23, .50), ‘other’ combustibles (APR = .47, 95% CI: .37, .58), and smokeless tobacco (APR = .40, 95% CI: .25, .65) use trended downward in 2020. Polytobacco use with and without e-cigarettes trended downward in 2020 compared to 2014. We also saw differences in trends across sociodemographic groups. Comparing 2020 to 2014, exclusive e-cigarette use was higher for females than males, ‘other’ combustible tobacco use remained stable for Non-Hispanic Black students but decreased for other racial/ethnic groups, and dual e-cigarette/cigarette use trended upward more for middle school students than high school students. Conclusions Despite decreased trends in tobacco product use without e-cigarettes between 2014-2020, differences in tobacco product use trends by grade level, sex, and race/ethnicity were identified. Prevention efforts targeting disparities in tobacco product use are needed.