The use of E-cigarettes among U.S. immigrants: The 2014 national health interview survey

Objective. Although e-cigarette popularity has increased substantially in recent years in the United States, it is unclear whether e-cigarette use has extended to immigrants in the United States. We characterized differences in ever and current use of e-cigarettes among non-U.S. citizens, naturalized U.S. citizens, and U.S. natives. Methods. We used cross-sectional data from the 2014 National Health Interview Survey to measure the prevalence of e-cigarette ever and current use by immigration status, characterized as U.S. native, naturalized U.S. citizen, and non-U.S. citizen. We used multivariate logistic regression to examine the association between e-cigarette use and immigration status adjusting for demographic characteristics, socioeconomic status, and history of tobacco use. We also stratified the use of e-cigarettes by cigarette smoking status and analyzed the impact of length of residency and country of origin on e-cigarette use among immigrants. Results. Naturalized U.S. citizens and non-U.S. citizens had a similar prevalence of e-cigarette use, which was significantly lower than the prevalence among U.S. natives. After adjusting for covariates, naturalized U.S. citizens had 38% lower odds and non-U.S. citizens had 54% lower odds of ever using e-cigarettes than U.S. natives. Non-U.S. citizens were less likely than U.S. natives to currently use e-cigarettes. Among both current smokers and nonsmokers of tobacco cigarettes, non-U.S. citizens were less likely than U.S. natives to indicate current e-cigarette use. U.S. immigrants with >5 years residency were more likely than U.S. immigrants with >5 years residency to try e-cigarettes. Conclusion. Although non-U.S. citizens are less likely than U.S. natives to currently use e-cigarettes, e-cigarette use may increase with length of residency in the United States.