Disposable e-cigarette use and associated factors in US middle and high school students, 2021-2022

Disposable e-cigarettes are the predominant type of vaping product used by adolescents and pose a significant public health concern. Identifying factors contributing to this growing trend is essential to curbing the vaping epidemic among youths. This study aims to investigate the growing prevalence and correlates of disposable e-cigarette use among US students.

Data from 48437 US middle and high school students from the 2021 and 2022 National Youth Tobacco Survey (NYTS) were analyzed using logistic and ordinal regression models to evaluate disposable e-cigarette use and frequency of use (low, medium, and high) with demographic and psychosocial factors. Weighted prevalence of current e-cigarette use with 95% CIs by device types in 2021 and 2022, were calculated. Odds ratios (ORs) of correlations of disposable e-cigarette use and frequency of use with demographic and psychosocial factors were analyzed.

Disposable e-cigarette use increased from 3.9% (95% CI: 3.3-4.7) in 2021 to 5.1% (95% CI: 4.2-6.1) in 2022, and was associated with being female (OR=1.57; 95% CI: 1.29-1.91 vs male), high schoolers (OR=5.14; 95% CI: 3.96-6.67 vs middle schoolers), having low harm perceptions of e-cigarettes (OR=7.75; 95% CI: 5.58-10.75 vs lot of harm), and high exposure to marketing (OR=1.57; 95% CI: 1.05-2.35 vs low exposure). Identifying as LGBTQ (OR=1.41; 95% CI: 1.00-2.00 vs straight), having low academic performance (OR=2.16; 95% CI: 1.15-4.07, D vs A grades), and having psychological distress (OR=2.01; 95% CI: 1.64-2.47, severe vs none) were also linked to increased frequency of use.

This study underscores increasing disposable e-cigarette use among US students, noting existing disparities. It identifies high-risk adolescent subgroups vulnerable to disposable e-cigarette use. These findings emphasize the urgency of targeted prevention and stricter regulations on disposable e-cigarettes to combat nicotine addiction among youths.