Race/ethnicity modifies the association between school prevalence of e-cigarette use and student-level use: Results from the 2014 US National Youth Tobacco Survey

This study assessed racial/ethnic moderation of the association between school prevalence of lifetime e-cigarette use and students' use. Using multilevel regression methods and data from the 2014 US National Youth Tobacco Survey, we found attending schools with high rates of e-cigarette use was positively associated with students' lifetime use of e-cigarettes, especially for white students. A cross-level interaction term indicated a weaker association between non-Hispanic black race and attending high-use schools (odds ratio [OR] =0.61, 95% confidence interval [CI] =0.39, 0.95). Results implicate race/ethnicity as an important effect modifier in the link between school contexts and teenage e-cigarette use.