Factors associated with disposable electronic cigarette use among US youth: A national repeated cross-sectional study, 2021–22

Background and aims: Disposable electronic cigarette (e-cigarette) use is becoming more popular among US youth, given the shifting landscape in product marketing, availability and regulation. This study aimed to estimate the prevalence of and test factors associated with the most used e-cigarette product (disposable versus other) among US youth aged 9–18 years who currently use e-cigarettes. Design, setting and participants: This was an observational study using cross-sectional data from the US-based 2021 and 2022 National Youth Tobacco Surveys (n = 48 704). We restricted our analytical sample to youth who currently use e-cigarettes (n = 4137). The sample ranged from 9 to 18 years old and was 53.0% female. Measurements: We dichotomized e-cigarette device type to disposable versus all other types (e.g. refillable pods/cartridges). We conducted logistic regression to estimate whether age, sex, race/ethnicity, sexual orientation, frequency of e-cigarette use, nicotine vaping, flavored e-cigarette use and current combustible/non-combustible tobacco use were associated with disposable e-cigarette use, compared with other e-cigarette use. Findings: Among youth who currently use e-cigarettes, 54.5% used disposable e-cigarettes. Older age (17–18 years), relative to younger age (9–14 years) [odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.07–1.91], non-Hispanic Black (versus non-Hispanic White) race/ethnicity (OR = 1.47, 95% CI = 1.01–2.15), any nicotine (versus non-nicotine) vaping (OR = 2.51, 95% CI = 1.96–3.23) and flavored (versus non-flavored) e-cigarette use (OR = 1.93, 95% CI = 1.46–2.56) were associated with increased odds of mainly using disposable e-cigarettes, compared with using other e-cigarette products, whereas current combustible tobacco use (versus non-current) (OR = 0.65, 95% CI = 0.53–0.80) and current non-combustible tobacco use (versus non-current) (OR = 0.58, 95% CI = 0.43–0.78) were associated with lower odds. Conclusion: Disposable e-cigarettes appear to be the most used type of e-cigarette product among US youth. Older age, non-Hispanic Black race/ethnicity, nicotine vaping and flavored e-cigarette use are associated with mainly using disposable e-cigarettes, relative to other e-cigarette products.