Examining Disparities in the Use of Electronic Vapor Products (EVPs) among the US Youths

Background: Electronic vapor products (EVPs) use is more common than cigarette smoking among US youths. EVPs may contain nicotine which is highly addictive, and the aerosol generated has carcinogens and toxic chemicals. Although public health efforts to reduce EVP use are in place, some demographic groups continue to experience a higher burden. In particular, sexual minorities are exposed to targeted marketing strategies and normative influence in social networks which puts them at increased risk. However, little is known about the prevalence of EVPs among sexual minority youths living in the US. This study aims to (1) identify sociodemographic characteristics associated with the use of EVP among US youths and (2) determine if EVP use disparities exist among sexual minorities. Methods: The 2019 Youth Risk Behavior Surveillance (YRBS) data for the entire US were used to assess demographic correlates of EVP use among high school students. The study sample was a nationally representative sample of students in grades 9-12 (n=13677). The CDC's YRBS data portal was used for analysis. T-test was used to identify statistical significance among variables and the level of significance was p< .05. Results: About 50.1% of US youths reported ever using EVPs. Non-Hispanic Black (p-value < .001), Hispanic/Latino (p-value < .001), and Asians (p-value < .001) were significantly less likely to ever use EVPs as compared to Non-Hispanic White students. More than half (56.0%) of students who identified as sexual minorities (gay/lesbian/bisexual students) reported ever using EVPs and sexual minorities were significantly more likely to have ever used EVPs as compared to heterosexual individuals (p-value < .001). Further, 71.4% of the students whose sexual contacts were same-sex only or both sexes reported ever using EVPs. Conclusion: The use of electronic vapor products is significantly high among Non-Hispanic White students and sexual minorities. This finding highlights the existence of disparities in EVP use and warrants the need for developing evidence-based strategies focusing on high-risk groups. Tailored efforts that can reach sexual minorities, combined with regulatory efforts from FDA, should be launched to reduce EVP use. Future research should focus on the factors influencing EVP use among sexual minorities such that specific areas could be targeted.