Sean Esteban McCabe1, Carol J Boyd2, Rebecca J Evans-Polce3, Vita V McCabe4, Phil T Veliz5. 1. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan; Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan. Electronic address: plius@umich.edu. 2. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan; Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, Michigan. 3. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan. 4. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan; St. Joseph Mercy Ann Arbor, St. Joseph Mercy Health System, Ypsilanti, Michigan. 5. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
Abstract
PURPOSE: The aim of this study was to examine the school-level prevalence and predictors of e-cigarette use among U.S. adolescents. METHODS: The Monitoring the Future study is an annual national cross-sectional study of secondary (middle and high) school students. This study uses 2015 and 2016 survey data from 8th, 10th, and 12th grade students (n = 38,926) attending 580 U.S. public and private secondary schools. E-cigarette use, binge drinking, cigarette smoking, marijuana use, and nonmedical prescription drug use were measured at the individual level. School-level characteristics were measured with both aggregated student-level measures (e.g., school-level e-cigarette use, school-level racial composition) and school characteristics (e.g., public vs. private, urban vs. rural). RESULTS: The prevalence of past-month e-cigarette use varied considerably across 580 U.S. middle and high schools, ranging from 0% to 60% at individual schools (mean = 10.2%, standard deviation = 8.9%). Multivariable regression analyses indicated that past-month e-cigarette use was significantly higher at schools with a higher proportion of White students, schools that were located in the U.S. Southern and Western regions, and schools with higher prevalence of past-month cigarette smoking, after controlling for relevant individual- and school-level covariates. CONCLUSIONS: E-cigarette use varies considerably across schools, and this study suggests that school context plays an important role in e-cigarette use. Cigarette smoking and e-cigarette use at the school level are closely linked and are important risk factors for individual-level e-cigarette use. The wide variation in prevalence of e-cigarette use highlights the need for schools to work with professionals to obtain school-level assessment rather than relying solely on state or national results to guide prevention efforts.
PURPOSE: The aim of this study was to examine the school-level prevalence and predictors of e-cigarette use among U.S. adolescents. METHODS: The Monitoring the Future study is an annual national cross-sectional study of secondary (middle and high) school students. This study uses 2015 and 2016 survey data from 8th, 10th, and 12th grade students (n = 38,926) attending 580 U.S. public and private secondary schools. E-cigarette use, binge drinking, cigarette smoking, marijuana use, and nonmedical prescription drug use were measured at the individual level. School-level characteristics were measured with both aggregated student-level measures (e.g., school-level e-cigarette use, school-level racial composition) and school characteristics (e.g., public vs. private, urban vs. rural). RESULTS: The prevalence of past-month e-cigarette use varied considerably across 580 U.S. middle and high schools, ranging from 0% to 60% at individual schools (mean = 10.2%, standard deviation = 8.9%). Multivariable regression analyses indicated that past-month e-cigarette use was significantly higher at schools with a higher proportion of White students, schools that were located in the U.S. Southern and Western regions, and schools with higher prevalence of past-month cigarette smoking, after controlling for relevant individual- and school-level covariates. CONCLUSIONS: E-cigarette use varies considerably across schools, and this study suggests that school context plays an important role in e-cigarette use. Cigarette smoking and e-cigarette use at the school level are closely linked and are important risk factors for individual-level e-cigarette use. The wide variation in prevalence of e-cigarette use highlights the need for schools to work with professionals to obtain school-level assessment rather than relying solely on state or national results to guide prevention efforts.