Sexual Minority Youth E-Cigarette Use

BACKGROUND AND OBJECTIVES: There is consistent evidence that sexual minority youth (SMY) use more traditional cigarettes than their non-SMY counterparts. However, there is relatively less information on e-cigarettes and, importantly, differences between and within SMY populations by race and ethnicity and sex. This study examines e-cigarette use by sexual orientation status and the intersection of race and ethnicity and sex. METHODS: Data come from high school students in the 2020 and 2021 National Youth Tobacco Surveys (N 5 16 633). Current e-cigarette use prevalence by sexual identity categories was calculated for racial and ethnic subgroups. Multivariable logistic regression analysis examined the association between sexual identity and e-cigarette use by race and ethnicity groups and sex. RESULTS: E-cigarette use prevalence was higher for most SMY racial and ethnic groups than their non-SMY counterparts. However, multivariable logistic analysis showed varied results by race and ethnic groups, with higher e-cigarette use odds for SMY populations, although not statistically significant for some race and ethnic groups. Black gay or lesbian (adjusted odds ratio: 3.86, 95% confidence interval, 1.61–9.24) and bisexual (adjusted odds ratio: 3.31, 95% confidence interval, 1.32–8.30) high school students had significantly higher e-cigarette use odds than Black heterosexuals. Non-Hispanic Black females e-cigarettes use odds are 0.45 times that of non-Hispanic white males, and non-Hispanic other gay or lesbian had 3.15 times higher e-cigarette use odds than non-Hispanic white heterosexuals. CONCLUSIONS: E-cigarette use is more prevalent among SMY populations. Disparities in e-cigarette use vary depending on race and ethnicity and sex.