Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students - United States, 2014-2017 - PubMed (original) (raw)

Racial/Ethnic Disparities in Tobacco Product Use Among Middle and High School Students - United States, 2014-2017

Satomi Odani et al. MMWR Morb Mortal Wkly Rep. 2018.

Abstract

During the past few decades, wide disparities in tobacco product use have been documented among the largest racial/ethnic groups in the United States (1,2); however, little is known about tobacco product use among youths from racial/ethnic groups other than whites, blacks, and Hispanics. Surveillance reports typically aggregate these racial/ethnic minorities into a single category because of small sample sizes (3). To assess tobacco product use among U.S. middle and high school students from seven racial/ethnic groups (non-Hispanic whites [whites], non-Hispanic blacks [blacks], Hispanics, non-Hispanic Asians [Asians], non-Hispanic American Indian/Alaska natives [AI/ANs], non-Hispanic Native Hawaiians/Other Pacific Islanders [NHOPIs], and non-Hispanic multiracial persons [multiracial]), CDC analyzed pooled data from the 2014-2017 National Youth Tobacco Surveys (NYTS). Prevalence of ever (≥1 time in lifetime) and current (≥1 time in past 30 days) use of seven tobacco products (cigarettes, cigars, smokeless tobacco, electronic cigarettes [e-cigarettes], hookahs, pipes, and bidis) was assessed; any tobacco product use was defined as use of one or more tobacco products, including hand-rolled cigarettes. During 2014-2017, ever-use of any tobacco product among U.S. middle and high school students was as follows: NHOPIs (45.1%), AI/ANs (43.8%), multiracial persons (38.2%), Hispanics (35.1%), blacks (32.3%), whites (32.0%), and Asians (16.3%). Current use of any tobacco product was as follows: NHOPIs (23.4%), AI/ANs (20.6%), multiracial persons (16.5%), whites (15.3%), Hispanics (14.6%), blacks (11.5%), and Asians (5.0%). Among black middle and high school students, cigars were the most common product currently used, whereas e-cigarettes were the most commonly used product for all other racial/ethnic groups. Comprehensive and sustained implementation of evidence-based, population-level tobacco control interventions could reduce prevalence and disparities in tobacco product use among U.S. youths.

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Conflict of interest statement

All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Figures

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FIGURE

Adjusted prevalence ratios of current use of any tobacco product among middle and high school students — National Youth Tobacco Survey, United States, 2014–2017, Abbreviations: AI/AN = American Indians/Alaska Natives; NHOPI = Native Hawaiian/Other Pacific Islander. * Adjusted prevalence ratios and 95% confidence intervals (presented as whiskers) were obtained using Poisson regression models adjusted for sex and school level, with the group with the lowest prevalence of current use of any tobacco product (Asians, 5.0%) serving as the referent. Among other racial and ethnic groups, prevalence was NHOPIs 23.4%; AI/ANs 20.6%; multiracial 16.5%; whites 15.3%; Hispanics 14.6%; and blacks 11.5%. † Current (≥1 time in the past 30 days) use of any tobacco product was defined as current use of one or more tobacco product types, including cigarettes, cigars (including cigarillos and little cigars), smokeless tobacco (including chewing tobacco, snuff, dip, snus, and dissolvable tobacco), electronic cigarettes, hookahs, pipes, bidis, and hand-rolled cigarettes. § Data were pooled across four cycles of NYTS (2014–2017) to increase precision of estimates among racial and ethnic minorities. Pooled sample sizes for each racial/ethnic group during 2014–2017 were 32,358 whites; 11,664 blacks; 21,337 Hispanics; 3,321 Asians; 1,213 AI/ANs; 456 NHOPIs; and 4,106 multiracial. ¶ All racial/ethnic groups assessed are non-Hispanic, unless otherwise specified.

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