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To examine changes from 2017 to 2018 in e‐cigarette use and ever marijuana use with e‐cigarettes among US adolescents.
Analysis of data from the 2017 and 2018 National Youth Tobacco Survey (NYTS), cross‐sectional surveys of US middle school (grades 6–8) and high school (grades 9–12) students.
US adolescent population from middle school, with mean age 12.7 (SD:1.0) years, and high school, with mean age 16.1 (SD:1.3) years.
Analysis of e‐cigarette use and ever use of marijuana with e‐cigarettes according to frequency of use and smoking status, comparing 2017 with 2018. Frequent smoking and e‐cigarette use was defined as use for ≥ 20 of the past 30 days.
Past 30 days e‐cigarette use was reported by 33.1% (95% CI 29.1‐37.4%) of ever/no past 30 days smokers, 68.6% (95%CI:64.1‐72.7%) of past 30 days smokers and 7.2% (95% CI:6.3‐8.2%) of never smokers in 2018, and by 19.3% (95%CI:16.1‐23.1%), 53.0% (95% CI:46.9‐58.9%) and 3.3% (95%CI:2.7‐4.4%) in 2017, respectively (all P<0.001). Prevalence of past 30 days e‐cigarette use was higher among frequent smokers (69.8%, 95%CI:62.3‐76.5% in 2018; 53.8%, 95%CI:44.1‐63.2% in 2017, P<0.001) and lower among never smokers. Most of the latter were infrequent users while frequent and daily e‐cigarette use was 18 and 24‐fold lower compared with ever smokers, respectively. Approximately half of past 30 days and 70% of frequent e‐cigarette users reported ever marijuana use with e‐cigarettes in both years. Past 30 days smokers were more likely to report past 30 days e‐cigarette use (OR:15.78, 95%CI:12.58‐19.83 in 2018; OR:16.11, 95%CI:12.44‐20.86 in 2017) compared with adolescents reporting no past 30 days smoking.
Among US adolescents, e‐cigarette use increased in all smoking groups in 2018 compared with 2017. Frequent and daily e‐cigarette use was by far lower in never‐smokers compared with ever‐smokers. High prevalence of ever marijuana use with e‐cigarettes was observed.