Study Finds Bigger Increase in Youth E-cigarette Use in Rural Areas Than in Urban Ones

A Midwestern study found distinct disparities in the increase of youth e-cigarette use, with a much larger recent increase in rural than in urban areas. The study, “Rural-Urban Differences in Changes and Effects of Tobacco 21 in Youth E-cigarette Use in Kansas,” which will be published in the May 2021 issue of Pediatrics (published online April 19), collected data from an annual state-wide survey of middle and high school students in Kansas. Of 132,803 participants, the prevalence of current e-cigarette use increased from 8.2% in 2018 to 12.6% in 2019. The increase was larger in rural areas (6.7% in 2018 to 13.4% in 2019) than in urban areas (9.8% to 11.9%). In 2019, over 5.2 million U.S.  adolescents reported current use of e-cigarettes with more than 1 in 4 students in the 12th grade and more than 1 in 5 in the 10th grade reporting use of e-cigarettes in the past 30 days. This study is one of the first to identify a significant disparity in changes of youth e-cigarette use across urban and rural areas, according to the authors. T21 policies, which raise the legal age to 21 to buy tobacco products, may curb increases in e-cigarette use among youth, and more efforts to reduce e-cigarette use, especially in rural areas, are needed, the authors conclude.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.