A Longitudinal Analysis of E-Cigarette Initiation Predicted by Peer Use Among U.S. Youth and Young Adults by Sexual and Gender Minority Identity, 2021–2023

Purpose Sexual and gender minority (SGM) people report higher rates of e-cigarette use than non-SGM people. Further investigation is needed to understand the role of peer e-cigarette use in e-cigarette uptake by identity.Methods This study used longitudinal data (2021–2023) to explore the association of peer use and SGM e-cigarette initiation among US young people who have never used tobacco (N = 3136). Logistic regression analyses examined if peer e-cigarette use at baseline predicted e-cigarette initiation for SGM and non-SGM individuals.Results SGM participants reported greater initiation (14.7% vs. 8.9%) and greater peer use (12.2% vs. 8.4%), compared to non-SGM. SGM and non-SGM participants who reported greater peer use saw greater odds of subsequent initiation (SGM: aOR: 1.75, 95% CI: 1.08, 2.85; Non-SGM: aOR: 2.72, 95% CI: 1.63, 4.52).Discussion Peer use may predict e-cigarette initiation among both SGM and non-SGM young people.