Healthy People 2020: Social Determinants of Cigarette Smoking and Electronic Cigarette Smoking among Youth in the United States 2010-2018.

The purpose of this study was to determine social determinants of cigarette smoking and ever using electronic cigarettes (e-cigarettes) among young adults aged 18 to 25 years in the United States between 2010 and 2018. Using secondary data from National Health Interview Surveys (NHIS) across the 2010, 2014, and 2018 survey years, this study analyzed the prevalence rates of cigarette smoking and ever using e-cigarettes between 2010 and 2018, demographic and socioeconomic disparities in smoking, and the relationship between previous e-cigarette use and current smoking. First, the past decade witnessed a notable decline in conventional cigarette smoking and a sharp increase in e-cigarette use among youth. These trends were consistent regardless of socioeconomic status. Second, demographic and socioeconomic disparities persisted in cigarette smoking. Non-Hispanic white male youth were more likely to become smokers as they grew older. Young people with lower educational attainment, living below the U.S. federal poverty level, and having a poor physical health status had a higher smoking prevalence. Third, previous e-cigarette use was more likely to relate to subsequent cigarette use among young people. To achieve the Healthy People 2020 objectives, tobacco control programs and interventions need to be more specific in higher prevalence groups and service providers should not assume that there is a one-size-fits-all model for youth.