Racial and nonracial discrimination and tobacco use among high school students in California

Background: The public health literature has established a relationship between discrimination, health outcomes, and health and well-being in adolescence. The objective of this study is to add vaping to the existing studies on discrimination and tobacco use among youth. To achieve this objective, the analysis examined the relationship between discrimination, type of discrimination, and current tobacco use, including current vape use, among adolescents in California.

Methods: This study uses data from the 2023 California Youth Tobacco Survey, which was administered to a representative sample of middle and high school students (8th, 10th, and 12th graders) attending public and private schools in California. The analysis focused on high school students in public schools. Outcome variables were current use of any tobacco product and current vape use. Predictor variables were any, racial, and nonracial discrimination. Covariates included race/ethnicity, gender identity and sexual orientation, and age. Separate logistic regression models examined the relationship between any discrimination or racial and nonracial discrimination and current tobacco use or current vape use, adjusting for covariates. Analyses were adjusted by sampling weights and stratification variables to account for complex sampling techniques.

Results: Any, racial, and nonracial discrimination were associated with significantly higher odds of current tobacco use. Any discrimination was also associated with significantly higher odds of current vape use. Nonracial, but not racial, discrimination was significantly associated with significantly higher odds of current vape use.

Conclusion: The results of this analysis are consistent with other analyses demonstrating a significant positive relationship between experiences of discrimination and tobacco use. These results contribute to existing knowledge by revealing that this relationship also exists for vaping among youth. Discrimination remains a public health crisis, including for youth in California. Increased use of supportive, rather than punitive, tobacco control approaches and cessation resources should be considered for schools in California.