Introduction Despite declines in cigarette smoking in the US, electronic cigarette (e-cigarette) use has increased among middle and high school students. In 2014, New York City (NYC) implemented Tobacco 21 (T21) to prohibit sales to anyone under age 21. Our study goal was to measure the effectiveness of T21 on e-cigarette use. Methods We used the New York State (NYS) Youth Tobacco Survey—a biennial, school-based, self-administered survey. We explored middle (N = 5249) and high (N = 7296) school NYC students’ (male and female) current (past 30 days’) e-cigarette use from 2014 (pre-T21) to 2018 (post-T21). Results were compared with students in the rest of NYS (ROS). Bivariate and multivariable logistic regression analyses assessed correlates of e-cigarette use, beliefs about harmfulness, addictiveness, and susceptibility. Results NYC high school students’ current e-cigarette use increased from 2014 to 2018 (8.1% vs 23.5%, P < .001). Middle school students’ use increased between 2014 (4.8%) and 2016 (9.0%) yet reversed by 2018 (5.7%) (2014 vs 2018, P = .576). ROS middle school (2.2% vs 7.4%, P < .001) and high school (12.0% vs 29.3%, ( P < .001) use increased from 2014 to 2018. Willingness to try e-cigarettes among those who had never tried an e-cigarette was twice as high (AOR = 2.19, 95% CI = 1.15-3.17) among NYC high school students in 2018 compared with 2014. Conclusions E-cigarette use increased among NYC high school students despite T21. T21 may have reduced use among middle school students over time. Programs that denormalize e-cigarettes and policies that further restrict access are needed to decrease youth e-cigarette use.

We examined trends in hookah use among New York City middle and high school students. We calculated prevalences, linear trends, and odds ratios of ever and current hookah use, by selected demographic variables, using 2008 through 2014 data from the New York State Youth Tobacco Survey. The prevalence of ever hookah use increased overall from 2008 through 2014 (8.9% to 13.0%, P = .01); current use was stable during this period but increased across many demographic characteristics. Our results indicate a need for efforts to educate populations with increasing prevalence of hookah use as well as policies that regulate use to reduce and denormalize hookah smoking.

Colorectal cancer (CRC) incidence rates are rising in younger Americans and mortality rates are increasing among younger white Americans. We used New York State Cancer Registry data to examine New York City CRC incidence and mortality trends among adults ages 20–54 years by race from 1976 to 2015. Annual percent change (APC) was considered statistically significant at P less than .05 using a two-sided test. CRC incidence increased among those ages 20–49 years, yet blacks had the largest APC of 2.2% (1993–2015; 95% confidence interval [CI] = 1.4% to 3.1%) compared with 0.5% in whites (1976–2015; 95% CI = 0.2% to 0.7%). Among those aged 50–54 years, incidence increased among blacks by 0.8% annually (1976–2015; 95% CI = 0.4% to 1.1%), but not among whites. CRC mortality decreased among both age and race groups. These findings emphasize the value of local registry data to understand trends locally, the importance of timely screening, and the need for clinicians to consider CRC among all patients with compatible signs and symptoms.

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