Racial Disparities of E-Cigarette Use Among US Youths: 2014–2019

Objectives. To evaluate disparities in youth e-cigarette use patterns and flavor use by race/ethnicity over time. Methods. We used data from the US 2014–2019 National Youth Tobacco Survey (NYTS) to examine trends in dual use (co-use of e-cigarettes and cigarettes or other tobacco products), occasional (# 5 days) versus frequent use ($ 20 days) in the past 30 days, and flavor use among current (past-30-day) e-cigarette users (n 5 13 178) across racial/ethnic groups (non-Hispanic Whites, non-Hispanic Blacks, Hispanics/Latinos, and non-Hispanic others). Results. Among current e-cigarette users, dual use and occasional use decreased significantly from 2014 to 2019 across racial and ethnic groups except for non-Hispanic Blacks; frequent use and flavored e-cigarette use increased among non-Hispanic Whites, Hispanics/Latinos, and non-Hispanic others but not among non-Hispanic Blacks. In 2019, non-Hispanic Black e-cigarette users were more likely to report dual use (adjusted odds ratio [AOR] 5 2.2; 95% confidence interval [CI] 5 1.5, 3.2; P, .001) and occasional use of e-cigarettes (AOR 5 3.7; 95% CI 5 2.3, 5.9; P, .001) but less likely to report frequent use (AOR 5 0.2; 95% CI 5 0.1, 0.4; P, .001) and flavored e-cigarette use (AOR 5 0.4; 95% CI 5 0.3, 0.5; P, .001) than their White peers. Conclusions. Youth e-cigarette use patterns differed considerably across racial/ethnic groups, and tailored strategies to address disparities in e-cigarette use are needed.