Affiliation:
1. aUSC Institute for Addiction Science
2. bDepartment of Population and Public Health Sciences, Keck School of Medicine
3. cUSC Norris Comprehensive Cancer Center, Keck School of Medicine
4. dDepartment of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
Abstract
BACKGROUND AND OBJECTIVES
Flavored non-tobacco oral nicotine products (eg, nicotine pouches and nontherapeutic nicotine gum, lozenges, tablets, gummies), are increasingly marketed in the United States. Prevalence of non-tobacco oral nicotine product use among adolescents is unknown.
METHODS
We calculated prevalence of ever and past 6-month use of nicotine pouches, other non-tobacco oral nicotine products (ie, gum, lozenges, tablets, and/or gummies), e-cigarettes, cigarettes, hookah or waterpipe, cigars, cigarillos, and snus among high school students in Southern California between September and December 2021. Generalized linear mixed models tested associations of sociodemographic factors and tobacco-product use with use of any non-tobacco oral nicotine product.
RESULTS
Among the sample (n = 3516), prevalence was highest for e-cigarettes (ever: 9.6%, past 6-month: 5.5%), followed by non-tobacco oral nicotine products (ever: 3.4%, past 6-month: 1.7%), and <1% for other products. Ever users of combustible tobacco (adjusted odds ratio [aOR] = 77.6; 95% confidence interval [CI] = 39.7–152) and ever users of noncombustible tobacco (aOR = 40.4; 95% CI= 24.3–67.0) had higher odds of ever using non-tobacco oral nicotine products, compared to never users of combustible and noncombustible tobacco. Use of any non-tobacco oral nicotine product was greater for Hispanic (versus all other races/ethnicities except Asian, aOR = 2.58; 95% CI = 1.36–4.87), sexual minority (versus heterosexual, aOR=1.63; 95% CI = 1.03–2.57), gender minority (versus male, aOR = 2.83; 95% CI = 1.29–6.19), and female (versus male, aOR=1.92, 95% CI = 1.20–3.06) participants.
CONCLUSIONS
Non-tobacco oral nicotine products were the second most prevalent nicotine product used by adolescents. They were disproportionately used by certain racial or ethnic, sexual, or gender minority groups, and those with a history of nicotine use. Adolescent non-tobacco oral nicotine product use surveillance should be a public health priority.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology and Child Health
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