Hispanic and Latino Young Males With Higher Education, Greater Acculturation Are More Likely to Use E-Cigarettes

Hispanic and Latino young men with higher levels of education who were born in the United States and speak mostly English at home are more likely to use e-cigarettes, according to a Rutgers researcher.

In a study, published in American Journal of Medicine Open, researchers examined current and former use of e-cigarettes among individuals from six distinct Hispanic and Latino backgrounds.

Electronic cigarettes – also called e-cigarettes or electronic nicotine delivery systems (ENDS) – rose in popularity in 2014 when conventional cigarette use decreased among adults in U.S. However, little is known about e-cigarette use in ethnic minorities who have historically been disproportionately targeted by tobacco marketing and experienced significant tobacco-related health disparities.

While previous research has shown that tobacco use among Hispanic and Latino adults is lower than in non-Hispanic whites, conventional cigarette use is more common among individuals of Puerto Rican and Cuban backgrounds compared with those of Mexican and Central or South American backgrounds. Hispanic and Latino individuals with higher levels of acculturation – being U.S.-born and preferring English – were more likely to use tobacco products.

“ENDS products represent a potential disruptive innovation to traditional tobacco use, with adolescents and young adults experimenting with e-cigarettes,” said Ayana April-Sanders, an instructor at the Rutgers School of Public Health and lead author of the study. “This experimentation is a risk factor for progression to combustible cigarette smoking and nicotine-dependence, which could lead to a ‘tipping point’ phenomenon, where future generations experience a higher prevalence of nicotine dependence and tobacco-related disease compared with previous generations.”

The study, which is among the first to characterize e-cigarette use among people of Hispanic and Latino backgrounds, analyzed data from 11,275 adult participants of the Hispanic Community Health Study/Study of Latinos for current, former and ever use of ENDS products.

The researchers found 2 percent of adults surveyed were current ENDS users, while about 10 percent were former ENDS users. They also found that individuals of Puerto Rican and Mexican backgrounds were more likely to try ENDS than those of Dominican, South American, Cuban or Central American backgrounds.

Among Hispanic and Latino adults, researchers found a high use of ENDS among those under 45 years of age. Additionally, they found that young adults who had never smoked conventional cigarettes were using e-cigarettes, suggesting that ENDS may promote cigarette smoking and increase health risks from chronic exposure to toxic substances in ENDS products.

“Our findings could inform preventive and regulatory interventions targeted at Hispanic and Latino communities to protect public health,” said April-Sanders. “Public health messaging efforts should consider targeting greater acculturated younger Hispanic and Latino individuals and creating bilingual messaging efforts that may be more appropriate for less acculturated, older people.”

April-Sanders said future research needs to examine why non-tobacco users are turning to e-cigarettes and monitor ENDS use.

Collaborators of the study include individuals from the Department of Medicine and the Department of Epidemiology and Population Health at Albert Einstein College of Medicine; the Institute for Minority Health Research at the University of Illinois College of Medicine; the Department of Social Medicine at the University of North Carolina; the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease; Department of Preventive Medicine in the Feinberg School of Medicine at Northwestern University; the Division of Cardiovascular Medicine in the Department of Medicine, Diabetes and Obesity Center at the Institute of Molecular Cardiology at the University of Louisville; and the American Heart Association.  The research was conducted as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01‐HC65233), University of Miami (N01‐HC65234), Albert Einstein College of Medicine (N01‐HC65235), Northwestern University (N01‐HC65236), and San Diego State University (N01‐HC652237). Ayana K. April-Sanders, PhD is supported by the National Heart, Lung, and Blood Institute (5T32HL144456–03). Thanh-Huyen T. Vu, MD. PhD was supported by the National Heart, Lung, and Blood Institute (R03HL144902). Carlos J. Rodriguez, MD, MPH is supported by grants from the National Institutes of Health (R01 HL04199, 75N92019D00011, 1U01HL146204–01, 5R01HL144707) and the American Heart Association (5P50HL120163–04).