Ethnic Differences in Patterns of Cigarette and E-Cigarette Use Over Time Among Adolescents

Abstract

Little is known about whether adolescent cigarette and e-cigarette use patterns over time differ by ethnicity. Data were pooled from three prospective cohort studies of adolescents in California and Connecticut (baseline:2013–2014; 12-month follow-up:2014–2015; N =6258). Adjusted polytomous regression models evaluated the association of baseline exclusive ever e-cigarette use, exclusive ever cigarette use, ever use of both e-cigarettes and cigarettes (dual use) with past 30-day use at follow-up (exclusively e-cigarettes, exclusively cigarettes, dual use; no use at baseline/follow-up were the referent groups. Interaction analyses evaluated differences by race/ethnicity (Hispanic White [HW], non-Hispanic White [NHW], Other). A significant global interaction was observed for the association of baseline with follow-up tobacco use by ethnicity (p=0.009). Among NHW participants, ever e-cigarette or cigarette users at baseline (vs. never users) had significantly higher odds of every past-30 day use tobacco use pattern at follow-up. Among HW participants, compared with never users, exclusive e-cigarette users at baseline had increased odds of continued e-cigarette use (OR exclusive e-cigarettes =5.22; 95%CI:3.50,7.79; OR dual use =3.64; 95%CI:1.62,8.18) but not of transition to exclusive cigarette use at follow-up (OR exclusive cigarettes =1.27; 95%CI:0.47,3.46), and HW exclusive cigarette users at baseline had greater odds of continued cigarette use (OR exclusive e-cigarettes =12.3; 95%CI:5.87,25.8; OR dual use =3.82; 95%CI:1.06,13.7) but not of transition to exclusive e-cigarette use at follow-up (OR exclusive cigarettes =1.61; 95%CI:0.62,4.18). Findings that NHW youth report more transitional use patterns and HW youth report more stable use patterns suggest a potential for differential impacts of e-cigarettes, by ethnicity, in increasing subsequent transition to or cessation from cigarette smoking.