| Summary: | Introduction
There is growing public health concern about adolescent use of
heated tobacco products (HTPs) after the US Food and Drug Administration
approved the leading HTPs, IQOS, as a modified risk tobacco product. Extending
the previous studies examining the correlates of HTP use among adolescents, this
study aims to investigate potential risk factors for HTP use among US adolescents,
including the use of multiple tobacco and flavored tobacco products.
Methods
We analyzed the 2019 National Youth Tobacco Survey (n=19018) and
conducted a series of logistic regression models on awareness and use of HTPs
as a function of tobacco use status (none, single, dual/poly) and past 30 days
flavored tobacco use (e.g. menthol cigarette use, flavored e-cigarettes), controlling
for sociodemographics.
Results
In multivariable analyses, awareness of HTPs was associated with usual
menthol cigarette use (AOR=1.77; 95% CI: 1.23–2.53) and past 30 days flavored
tobacco use (AOR=1.44; 95% CI: 1.16–1.80). Risk factors for ever HTP use
included single (AOR=2.52; 95% CI: 1.19–5.33) and dual/poly tobacco use
(AOR=4.94; 95% CI: 2.56–9.54), usual menthol cigarette use (AOR=2.50; 95%
CI: 1.66–3.76), and past 30 days flavored tobacco use (AOR=1.61; 95% CI: 1.07–
2.44). Risk factors for current HTP use included single (AOR=10.84; 95% CI:
6.72–17.49) and dual/poly tobacco use (AOR=31.96; 95% CI: 17.79–57.43), and
usual menthol cigarette use (AOR=2.50; 95% CI: 1.63–3.85).
Conclusions
This study documents HTP use in adolescents and contributes insight
and urgency into prioritizing at-risk adolescents for interventions, including
current users of other tobacco products and flavored tobacco users.
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