E-Cigarette Brand Use by Race/Ethnicity in a US Sample of Adolescent and Young Adult E-Cigarette Users, 2022-2023.

Introduction: To determine whether e-cigarette brand use varies according to race/ethnicity among adolescent and young adult e-cigarette users.

Aims and methods: Data are from a cross-sectional online survey of respondents aged 15-24 years (January 2022-June 2023; 300 unique respondents/week). The analytic sample was restricted to current e-cigarette users (n = 6387). Respondents selected their usual brand and reported frequency of past 30-day e-cigarette use (in days). ANOVAs measured differences in frequency of use by usual brand, stratified by race/ethnicity. Linear regression identified changes in usual brand over time by race/ethnicity, controlling for age and use of other tobacco/nicotine products.

Results: One-quarter (25.6%) of Black and 22.2% of Hispanic e-cigarette users reported JUUL as their usual brand, compared to those who are White (15.7%) or another race (16.5%). Puff Bar was the second-most reported brand among Black (15.1%) or Hispanic (16.6%) e-cigarette users, to a greater extent than White (7.8%) e-cigarette users. Frequency of use varied significantly according to respondents' usual brand when stratified by race/ethnicity (p < .001).

Conclusions: Across all racial and ethnic categories, frequency of use was greater for brands marketed with more flavor options and containing nicotine (EB Design, SMOK, Hyde, and Vuse). Despite declines in popularity, Black or Hispanic respondents report using JUUL and Puff Bar to a greater extent than other respondents, and vape less frequently than White non-Hispanic respondents regardless of brand. As e-cigarette brands continue to proliferate, monitoring e-cigarette brand selection by race/ethnicity can inform studies of nicotine exposure, polyuse, and health disparities.

Implications: Our study demonstrates the importance of research methods to detect rapidly changing patterns of e-cigarette use by race/ethnicity and age. The inclusion of measures capturing brand use can detect evidence of product features and targeted marketing that may have consequences for patterns of tobacco use and nicotine exposure among these groups.