Sexual Minority Youth E-Cigarette Use

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. Data come from high school students in the 2020 and 2021 National Youth Tobacco Surveys (N = 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. 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. E-cigarette use is more prevalent among SMY populations. Disparities in e-cigarette use vary depending on race and ethnicity and sex.