E-cigarette Use Among Youth: Results from the 2019 South Dakota Youth Tobacco Survey.

Background: The prevalence of e-cigarette use among youth is increasing in an alarming rate nationwide with over 5 million students currently using e-cigarettes in 2019. To better understand e-cigarette use in South Dakota, we examined the prevalence, access, reasons, and harm perception of e-cigarette among South Dakota youth.

Methods: We analyzed a representative sample of sixth to eighth grade students from the 2019 South Dakota Youth Tobacco Survey (YTS). Weighted estimates were computed to account for the complex sampling design and estimates were analyzed by geographic location and race/ethnicity.

Results: Among the 2,346 students, the prevalence of ever use of e-cigarettes among middle school students was 16.0 percent, a nearly 100 percent increase from 2017 YTS findings (8.2 percent). Approximately, seven percent (6.7 percent) reported use of an e-cigarette in the past 30 days, a nearly threefold increase from 2017 results (2.5 percent). Prevalence of current e-cigarette use was significantly higher among American Indian (12.7 percent) students and rural (8.3 percent) school students. The most common reported reasons for e-cigarette use was having friends/ family members that use them (49.6 percent) but also availability of flavors (18.6 percent). E-cigarette users obtained e-cigarettes predominantly through social sources (e.g., friends and peers). Nearly 30 percent (27.3 percent) reported not having enough information about e-cigarette's harm.

Conclusions: In 2019, e-cigarettes were the most commonly used tobacco product among South Dakota middle school students. We found geographic and racial/ethnic disparity in e-cigarette use. Social influence and availability of flavors were important factors in promoting e-cigarette use. Continued efforts to implement population-level strategies to reduce e-cigarette use among youth are needed.