High school students rarely use e-cigarettes alone: A socio-demographic analysis of poly-substance use among adolescents in the USA
Menée aux Etats-Unis à partir de données 2017 portant sur 11 247 adolescents, cette étude analyse l'utilisation de cigarettes électroniques, seules ou avec d'autres substances (tabac, alcool, cannabis), en fonction de plusieurs facteurs sociodémographiques
Résumé en anglais
Most adolescents reporting e-cigarette use have also used combustible tobacco; however, the extent to which they use other substances is less clear. This study assessed e-cigarette use with tobacco, alcohol, or cannabis and quantified the risk of poly-substance use among adolescents overall and by socio-demographic characteristics.Using 2017 Youth Behavioral Risk Factor Surveillance System data from adolescents (grades 9-12) with complete substance use information (n=11,244), we examined e-cigarette poly-use status (none [referent]; e-cigarettes only; or e-cigarettes + other substances). We estimated prevalence of substance use and modeled odds of e-cigarette use, alone or with other substances, by several socio-demographic characteristics. Analyses were completed in Stata version 15.1 using survey procedures to account for the complex survey design.Approximately 12% of adolescents reported past 30-day e-cigarette use. Almost all (93%) e-cigarette users also reported other substance use; alcohol appeared most frequently in combinations. Odds of e-cigarette single use and e-cigarette poly-use (vs. no use) were higher for males and adolescents with lower grades (ORs 1.44-2.31). Racial/ethnic minorities had lower odds of e-cigarette poly-use than White peers (ORs 0.18-0.61), and bisexual (vs. straight) adolescents were more likely to be e-cigarette poly-users (OR=1.62). E-cigarette use increased from 9th grade (7%) to 12th grade (16%).Poly-substance use is highly prevalent among adolescents who use e-cigarettes. Therefore, e-cigarette screening should include assessment of other substances, especially alcohol. Early and comprehensive prevention efforts to reduce e-cigarette and other substance use could have a substantial beneficial impact on population health over time.
