Psychosocial and Behavioral Risk Profiles of Cigarette Smokers and E-Cigarette Users Among Adolescents in Minnesota: The 2016 Minnesota Student Survey

INTRODUCTION: Understanding differences in predictors of adolescent cigarette smoking and e-cigarette use can inform public health strategies for preventing and reducing tobacco use among this population. The objective of this study was to examine the association of socioeconomic, psychosocial, and behavioral factors with cigarette smoking and e-cigarette use among adolescents in Minnesota. METHODS: Records (n = 126,868) were used from the 2016 Minnesota Student Survey for prevalence of and factors associated with cigarette smoking and e-cigarette use among students in grades 8, 9, and 11. Logistic regression models were used to estimate risk for smoking cigarettes, using e-cigarettes, or concurrent use of both for key independent variables. RESULTS: American Indian students were 3.6 times as likely to report smoking cigarettes (OR = 3.57; 95% CI, 3.04–4.19), and 1.7 times as likely to report using e-cigarettes (OR = 1.72; 95% CI, 1.47–2.01) as non-Hispanic white students. Bisexual students were 4 times as likely (adjusted odds ratio [AOR] = 4.40; 95% confidence interval [CI], 4.01–4.82) as heterosexual students to smoke cigarettes and twice as likely (AOR = 2.24; 95% CI, 2.06–2.43) to use e-cigarettes. Students receiving free/reduced lunch were nearly twice as likely (AOR = 1.92; 95% CI, 1.80–2.05) to smoke cigarettes and 1.3 times as likely (AOR = 1.33; 95% CI, 1.27–1.39) to use e-cigarettes. Increasing alcohol use and decreasing academic performance were associated with increasing likelihood of cigarette smoking and e-cigarette use, more so with cigarette smoking. CONCLUSION: Results expand on existing research that show differences in psychosocial and behavioral risk factors between adolescent cigarette smokers and adolescent e-cigarette users.