Results of the Statewide 2017-18 California Student Tobacco Survey Shu-Hong Zhu, Ph.D. Yue-Lin Zhuang, Ph.D. Katherine Braden, M.P.H. Adam Cole, Ph.D. Anthony Gamst, Ph.D. Tanya Wolfson, M.A. Joan Lee, B.S. Carlos Ruiz, B.A. Sharon Cummins, Ph.D. Principal Investigator: Shu-Hong Zhu, Ph.D. Institution: Regents of the University of California, San Diego Address: 9500 Gilman Drive, #0905 La Jolla, CA 92093-0905 Phone: (858) 300-1056 Fax: (858) 300-1099 E-mail: [email protected] Contract #: CDPH-16-10109 Contract Period: 1/1/17-6/30/21 Suggested citation: Zhu S-H, Zhuang YL, Braden K, Cole A, Gamst A, Wolfson T, Lee J, Ruiz CG, Cummins SE (2019). Results of the Statewide 2017-18 California Student Tobacco Survey. San Diego, California: Center for Research and Intervention in Tobacco Control (CRITC), University of California, San Diego. Made possible by funds received from the California Department of Public Health, California Tobacco Control Program, Contract # CDPH-16-10109. i TABLE OF CONTENTS EXECUTIVE SUMMARY ............................................................................................................. 1 LIST OF TERMS......................................................................................................................... 4 Tobacco Products................................................................................................................. 4 Definitions of Product Use.................................................................................................... 4 Other Terms*....................................................................................................................... 5 CHAPTER 1 – Tobacco Use Behavior ......................................................................................... 6 Tobacco Product Use among High School Students ............................................................... 6 Demographic Categories ...................................................................................................... 7 Overall Prevalence of Tobacco Use by Demographics ............................................................ 7 Use of Specific Tobacco Products by Demographics .............................................................. 8 Use of Specific Tobacco Products by LGBTQ Community Affiliation.......................................12 Frequency of Current Tobacco Product Use .........................................................................13 Multiple Tobacco Product Use .............................................................................................13 Multiple Tobacco Product Use by LGBTQ Community Affiliation ...........................................14 Tobacco Use by Personal Characteristics..............................................................................15 Summary ............................................................................................................................16 CHAPTER 2 – Tobacco Use Behavior: Comparisons from 2015-16 to 2017-18 ...........................17 Tobacco Product Use among High School Students ..............................................................17 Tobacco Use by Demographics ............................................................................................18 Tobacco Product Use by Grade ............................................................................................19 Summary ............................................................................................................................20 CHAPTER 3 – Use and Opinions of Flavored Tobacco Products .................................................21 Flavored Tobacco Product Use among High School Students ................................................21 Flavored Tobacco Use by Demographics ..............................................................................22 Flavored Tobacco Product Use by Demographics .................................................................22 Use of Specific Flavor Types.................................................................................................25 Opinions of Flavored Tobacco Products ...............................................................................27 Summary ............................................................................................................................29 CHAPTER 4 – Susceptibility to Future Tobacco Use ..................................................................30 Susceptibility to Tobacco Product Use among High School Students .....................................30 Susceptibility to Tobacco Use by Demographics ...................................................................30 Susceptibility to Tobacco Use by Personal Characteristics ....................................................31 Susceptibility to Tobacco Use by Environmental Influences ..................................................32 Summary ............................................................................................................................34 CHAPTER 5 – Environmental Influences ...................................................................................35 Home Bans for Vaping and Smoking among High School Students ........................................35 Exposure to Secondhand Vapor and Smoke in the Last 30 Days among High School Students ...........................................................................................................................................37 Exposure to Secondhand Vapor and Smoke in the Last 30 Days by Race/Ethnicity ................38 ii Offers of Tobacco in the Last 30 Days among High School Students ......................................44 Offers of Tobacco Products by Demographics ......................................................................44 Exposure to Tobacco Ads in the Last 30 Days among High School Students ...........................46 Summary ............................................................................................................................52 CHAPTER 6 – Access to E-Cigarettes and Cigarettes .................................................................53 Acquisition of E-Cigarettes among High School Students ......................................................53 Acquisition of Cigarettes among High School Students .........................................................54 Sources of E-cigarettes and Cigarettes among High School Students Purchasing from a Store ...........................................................................................................................................55 Perceived Ease of Obtaining E-Cigarettes and Cigarettes .....................................................56 Summary ............................................................................................................................56 CHAPTER 7 – Geographic Differences ......................................................................................57 Tobacco Use by Urban Classification ....................................................................................57 Tobacco Use by 22 CSTS Sampling Regions ..........................................................................58 Tobacco Use by Priority Population Initiative Regions ..........................................................63 Tobacco Use by 4 Regions ...................................................................................................68 Summary ............................................................................................................................71 CHAPTER 8 – Marijuana Use ...................................................................................................72 Marijuana Use among High School Students .......................................................................72 Marijuana and Tobacco Co-Use by Demographics ................................................................73 Marijuana Use by Personal Characteristics...........................................................................75 Summary ............................................................................................................................76 CONCLUSION..........................................................................................................................77 APPENDIX A – 8th Grade Tobacco Use......................................................................................79 Tobacco Product Use among 8th Grade Students..................................................................79 Flavored Tobacco Product Use among 8th Grade Students....................................................79 Susceptibility to Tobacco Product Use among 8th Grade Students.........................................80 Comparisons from 2015-16 to 2017-18 among 8th Grade Students .......................................80 APPENDIX B – Survey Methodology of the 2017-18 California Student Tobacco Survey ............82 Survey Administration .........................................................................................................82 Sampling Strategy ...............................................................................................................82 Participation .......................................................................................................................82 Analysis ..............................................................................................................................83 Survey