Background:
Disposable e-cigarettes have emerged in the market and gained significant popularity, especially among adolescents. This has raised concerns about the potential addiction to nicotine and the associated health effects among this age group.

Objectives:
This study aims to investigate the prevalence of disposable e-cigarette use among middle and high school children in the United Stated, and to identify potential factors associated with usage and increased frequency of use in order to identify potential regulatory interventions.

Methods:
Data from 48,704 U.S. middle and high school students in the 2021 and 2022 National Youth Tobacco Survey (NYTS) were pooled to estimate disposable e-cigarette use. Multivariable logistic and ordinal regression models were used to assess demographic and psychosocial factors related to disposable e-cigarette use and frequency of use (low, medium, and high). All analyses were weighted to represent the national student sample.

Results:
The prevalence of current disposable e-cigarettes increased from 3.9% (n=744) in 2021 to 5.1% (n=1,443) in 2022 and were the most common type of e-cigarette used in both years. The modelling results indicated that, among all respondents, girls were 1.57 (95% CI:1.29-1.91) times more likely to be disposable e-cigarette users than boys, and high school students had 5.14 (95% CI: 3.96-6.67) times higher odds of being users than middle school students. Students of Hispanic, Black, Asian, and other ethnicities were less likely to use disposable e-cigarettes compared to White students (OR between 0.42 to 0.61). Among current disposable e-cigarette users, higher frequency of use was associated with self-identifying as LGBTQ+ (OR 1.41; 95% CI: 1.00-2.00 in comparison to straight), higher family affluence (OR 1.77; 95% CI: 1.16-2.71 in comparison to low), lower academic performance (OR 2.16; 95% CI: 1.15-4.07; self-reported grades of D’s in comparison to A's), and experiencing severe psychological distress (OR 1.49; 95% CI: 1.05-2.11 in comparison to non-distress).

Conclusions:
These findings underscore the need for enhanced and targeted prevention and regulatory measures to address the rising prevalence of disposable e-cigarette use among youth and curb nicotine addiction.