Racial and Ethnic Disparities in Adolescent Combustible Tobacco Smoking from 2014 to 2020: Declines are lagging among non-Hispanic Black Youth

We quantified the linear trend in combustible tobacco smoking among adolescents in the United States from 2014 to 2020, then compared these trends across racial and ethnic category. We also tested the effect of e-cigarette use on these trends for all youth and across racial and ethnic categories. We pooled and analyzed seven years of National Youth Tobacco Survey (NYTS) data for n=124,151 middle and high school students from 2014 to 2020. Weighted logistic regression analyses calculated the annual change in combustible tobacco smoking (i.e., cigarettes, cigars, and hookah) from 2014 to 2020. Stratified analyses examined linear trends for non-Hispanic White (NHW), NH-Black (NHB), Hispanic/Latino, and NH-Other (NHO) youth. All models controlled for sex, grade level, and past 30-day e-cigarette use. Combustible tobacco smoking from 2014 to 2020 dropped by more than 50% for NHW youth, more than 40% for Latino and NHO youth, compared to just 16% among NHB youth. From 2014 to 2020, odds of combustible tobacco smoking declined by 21.5% per year for NHWs, which was significantly greater than Hispanic/Latinos (17% per year; p=0.025), NHOs (15.4% per year; p=0.01), and NHBs (5.1% per year; p