Patterns and Correlates of Disposable E-Cigarette Use Among U.S. Youth

Area of Science:

• Public Health
• Adolescent Health
• Tobacco Control

Background:

• Youth disposable e-cigarette use is rising, but distinct user characteristics are understudied.
• Understanding these characteristics is crucial for targeted public health interventions.

Purpose of the Study:

• To analyze the characteristics and behaviors of U.S. youth engaging in different patterns of e-cigarette and tobacco product use.
• To identify risk factors associated with predominant disposable e-cigarette use versus other tobacco use patterns.

Main Methods:

• Cross-sectional analysis of the 2023 National Youth Tobacco Survey (N=22,069 U.S. students grades 6-12).
• Classification into six groups: predominant disposable e-cigarettes (no cigarettes), predominant non-disposable e-cigarettes (no cigarettes), cigarettes only, concurrent use (disposable or non-disposable), or no tobacco use.
• Assessment of e-cigarette use patterns, nicotine dependence, social media exposure, social norms, and psychological distress using weighted multinomial logistic regression.

Main Results:

• Predominant disposable e-cigarette users reported higher nicotine product use (81.9%) and fruit flavor preference compared to non-disposable users.
• 'Getting high from nicotine' was a primary motivation across e-cigarette groups.
• Predominant disposable e-cigarette use (without cigarettes) associated with daily social media exposure (RRR=2.1), peer e-cigarette use (RRR=1.2), and severe psychological distress (RRR=2.3).
• Concurrent cigarette and e-cigarette use showed strongest associations with dependence and social exposure.

Conclusions:

• Youth predominantly using disposable e-cigarettes exhibit nicotine-seeking behaviors and social media influence.
• Concurrent users of cigarettes and disposable e-cigarettes display elevated risks across multiple domains.
• Prevention strategies must be differentiated to address specific risk profiles of youth tobacco users.