scholarly journals Adult Use of and Transitions From Nicotine and Non-nicotine-Containing E-cigarettes: Data From the Population Assessment of Tobacco and Health (PATH) Study, 2013–2016

2019 ◽  
Vol 22 (7) ◽  
pp. 1225-1229
Author(s):  
Anh Nguyen Zarndt ◽  
Elisabeth A Donaldson ◽  
Jennifer K Bernat ◽  
James A Henrie ◽  
David B Portnoy
Keyword(s):  
Tobacco Use ◽  
Demographic Characteristics ◽  
Cigarette Use ◽  
Population Assessment ◽  
Product Use ◽  
Patterns Of Use ◽  
Sustained Use ◽  
Use Pattern

Abstract Introduction Studies largely focus on nicotine-containing e-cigarettes (NiCE) though non-nicotine-containing e-cigarettes (NoCE) exist; NoCE prevalence and patterns of use are largely unknown. This study examines self-reported prevalence and patterns of NiCE/NoCE use. Methods We analyzed adult (18+ years) data from the Population Assessment of Tobacco and Health (PATH) study from Wave 1 (2013–2014, n = 32,320), Wave 2 (2014–2015, n = 28,632), and Wave 3 (2015–2016, n = 28,148). We test associations between Wave 1 self-reported current NoCE/NiCE use status and demographic characteristics and assess the proportion of self-reported current NoCE/NiCE users at Wave 1 or Wave 2 who continue to use NoCE or NiCE, switch to NiCE or NoCE, discontinue e-cigarette use, switch to use other nicotine products (ONP), or add ONP use 1 year later (i.e., at Wave 2 or 3). Results Maintaining the same self-reported NiCE/NoCE and ONP use status 1 year later was the most common use pattern between waves. However, 15.65% of exclusive NoCE users in Wave 2 transitioned to NoCE plus nicotine product use in Wave 3. Also, some exclusive NoCE users transitioned to exclusive NiCE use (17.77% Waves 1–2; 11.55% Waves 2–3). Discussion Some exclusive NoCE users transitioned to NiCE or added nicotine product use, suggesting there may be other factors (e.g., familiarity with using an aerosolizing device) in addition to the presence of nicotine in influencing initiation or sustained use of nicotine products. Implications Studies largely focus on nicotine-containing e-cigarettes (NiCE) though non-nicotine-containing e-cigarettes (NoCE) exist; this study adds to the literature by describing demographic characteristics and tobacco use of adult self-reported NoCE users. In addition, the study examines transitions in self-reported NoCE/NiCE use, revealing that some exclusive NoCE users transition to other nicotine product use 1 year later.

Who Is Using Alternative Tobacco Products and Why?

2018 ◽  
Author(s):  
Alexandra Loukas ◽  
Deepti Agarwal
Keyword(s):  
Developmental Trajectories ◽  
The United States ◽  
Future Research ◽  
Cigarette Use ◽  
Longitudinal Models ◽  
Tobacco Products ◽  
Factors Associated ◽  
Product Use ◽  
Patterns Of Use ◽  
Alternative Tobacco Products

There is a growing array of alternative tobacco and nicotine products, such as hookah, cigarillos, snus, and electronic nicotine delivery systems (e-cigarettes). Both e-cigarette and hookah use are now more prevalent than cigarette use among adolescents in the United States. Alternative products are appealing to adolescents and young adults because they are available in a variety of flavors, often cheaper than cigarettes, and perceived to be less harmful than cigarettes. Existing studies are beginning to provide important information on the prevalence, correlates, and patterns of alternative tobacco and nicotine product use. Longitudinal models that map developmental trajectories and transitions of tobacco and nicotine use are needed to examine factors associated with persistence, progression, or desistence of use and also with changes in patterns of use. Future research can draw on developmental traditions in other areas of substance use to describe the heterogeneity in product use across time.

scholarly journals Data Visualization Tools of Tobacco Product Use Patterns, Transitions and Sex Differences in the PATH Youth Data

2020 ◽  
Vol 22 (10) ◽  
pp. 1901-1908 ◽  
Author(s):  
Ralitza Gueorguieva ◽  
Eugenia Buta ◽  
Patricia Simon ◽  
Suchitra Krishnan-Sarin ◽  
Stephanie S O’Malley
Keyword(s):  
Sex Differences ◽  
Data Visualization ◽  
Tobacco Use ◽  
Tobacco Product ◽  
Heat Maps ◽  
Use Patterns ◽  
Product Use ◽  
Patterns Of Use ◽  
Set Intersection ◽  
Visualization Tools

Abstract Introduction Evaluations of multiple tobacco product use and temporal changes in patterns of use are complicated by a large number of combinations and transitions. Visualization tools could easily identify most common patterns and transitions. Methods Set intersection bar plots describe ever use of five tobacco products among 12–17 years old youth in wave 1 of the Population Assessment of Tobacco and Health (PATH) study (N = 11 497). Heat maps visualize unweighted frequencies of transitions from ever use at wave 1 (2013–2014) to past 12-month use at wave 2 (2014–2015). Weighted calibrated heat maps assess differences in relative frequencies of transitions by pattern at wave 1 and identify differences in transitions by sex. Results The most common tobacco product ever use patterns in wave 1 were of cigarettes only, e-cigarettes only or hookah only, followed by ever use of both cigarettes and e-cigarettes. Initiation of use between waves was uncommon. The most frequent transition among those who reported use at wave 2 but not at wave 1 (N = 971) was to e-cigarette use (N = 301). However, among e-cigarette-only ever users at wave 1 (N = 260), about half did not report any product use at wave 2. Use of three or more products remained stable. Adolescent girls compared to boys appeared more likely to report hookah use at both waves. Conclusion Set intersection bar plots and heat maps are useful for visualizing tobacco product use patterns and transitions, especially for multiple products. Both techniques could identify common problematic tobacco use patterns across and within populations. Implications Given the growing complexity of the youth tobacco use landscape, approaches to efficiently communicate patterns of multiple tobacco product use should be used more often. This study introduces set intersection bar plots and modified versions of heat maps to the tobacco product literature and illustrates their use in the PATH youth sample. These techniques are useful for visualizing absolute and relative frequencies of multiple possible patterns and transitions. They also suggest targets for subsequent statistical inference such as sex differences in hookah use. The methods can be applied more generally for data visualization wherever large number of combinations occurs.

scholarly journals Age of initiation of cigarillos, filtered cigars and/or traditional cigars among youth: Findings from the Population Assessment of Tobacco and Health (PATH) study, 2013–2017

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243372
Author(s):  
Baojiang Chen ◽  
Kymberle L. Sterling ◽  
Meagan A. Bluestein ◽  
Arnold E. Kuk ◽  
Melissa B. Harrell ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Proportional Hazards ◽  
Interval Censoring ◽  
Cox Proportional Hazards ◽  
Population Assessment ◽  
Regulatory Policies ◽  
Product Use ◽  
Cox Proportional Hazards Models ◽  
Interval Censored ◽  
Hispanic White

Significance Early age of initiation of tobacco use is associated with sustained tobacco use and lower rates of smoking cessation. Although much is known about age of initiation of cigarette use, much less is known about the age of initiation of cigar product use among youth. Methods Survival analyses of the Population Assessment of Tobacco and Health youth annual datasets (ages 12–17) from 2013 to 2017 were conducted for any cigar product use, cigarillos or filtered cigars, and traditional cigars across four cigar use outcomes, age of initiation of: susceptibility to use, ever use, past 30-day use and “fairly regular” use. An interval censoring survival method was implemented to estimate the probability of each outcome for age of initiation of each cigar product overall. Differences in age of initiation by sex and race/ethnicity were assessed using weighted Cox proportional hazards models for interval-censored data. Results For each outcome across the three cigar products, striking increases in the probability of initiation begin before 17 years old. For cigarillo or filtered cigars, males had a higher risk of onset of susceptibility to use, initiating ever use, and initiating past 30-day use at earlier ages than females. Compared to Non-Hispanic Whites, Hispanic and Non-Hispanic Other had lower risk of initiating ever use and past 30-day use at earlier ages. Non-Hispanic Black youth had higher risk of initiating past 30-day use and “fairly regular” use than Non-Hispanic White youth at earlier ages. Similar findings are reported for any cigar use and traditional cigar use. Conclusion Developmentally and culturally appropriate cigar use interventions and communication campaigns should be provided to youth before 17 years of age to prevent the onset and progression of cigar products. Regulatory policies that reduce appeal of all cigar products should be implemented to curb cigar initiation among youth.

scholarly journals Flavored Tobacco Product Use and Its Association With Indicators of Tobacco Dependence Among US Adults, 2014–2015

2019 ◽  
Vol 22 (6) ◽  
pp. 1004-1015 ◽  
Author(s):  
Satomi Odani ◽  
Brian Armour ◽  
Israel T Agaku
Keyword(s):  
Tobacco Use ◽  
Tobacco Dependence ◽  
Tobacco Product ◽  
Demographic Characteristics ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Product Use ◽  
Menthol Cigarettes ◽  
Current Tobacco ◽  
Flavored Tobacco

Abstract Introduction Widely marketed flavored tobacco products might appeal to nonusers and could be contributing to recent increases in tobacco product use. We assessed flavored product use among current tobacco users; and measured associations between flavored product use and dependence among US adults. Methods Data were from the 2014–2015 Tobacco Use Supplement to the Current Population Survey, a cross-sectional household-based survey of US adults ≥18 years (n = 163 920). Current users of cigarettes, cigars, pipes, hookahs, smokeless tobacco, and electronic cigarettes (e-cigarettes) were asked whether their usual product was menthol or came in any characterizing flavors. Proportions of flavored product users were computed nationally and by state and demographic characteristics. Tobacco dependence was assessed with two proxy measures: daily use and use ≤30 minutes after waking. Associations between flavored product use and tobacco dependence were examined using logistic regression adjusted for sex, age, race/ethnicity, and multi tobacco product use. Results An estimated 41.0% of current users of any tobacco product usually used a flavored product during 2014–2015. The proportion ranged from 22.5% (Maine) to 62.1% (District of Columbia). By product, the proportion ranged from 28.3% (cigars) to 87.2% (hookah). Flavored product use was associated with: daily tobacco product use among current e-cigarette users (adjusted odds ratio [AOR] = 1.71), cigar smokers (AOR = 1.42), and cigarette smokers (AOR = 1.13); and tobacco product use ≤30 minutes after waking among current cigar smokers (AOR = 1.80), and cigarette smokers (AOR = 1.11). Conclusions Restricting sales of flavored tobacco products and implementation of proven population-level tobacco control interventions could help reduce tobacco product use among US adults. Implications During 2014–2015, flavored tobacco products were widely used by US adults with variations across states and demographic characteristics. Use of flavored e-cigarettes, flavored cigars, and menthol cigarettes were associated with daily tobacco use: use of flavored cigars and menthol cigarettes were associated with tobacco use within 30 minutes after waking. These findings suggest associations between flavor use and increased tobacco dependence. Prohibiting sale of flavored products can reduce access to those products, and could help reduce tobacco dependence and promote cessation behaviors among current tobacco product users.

scholarly journals Tobacco Use Prevalence and Transitions From 2013 to 2018 Among Adults With a History of Cardiovascular Disease

2021 ◽  
Author(s):  
Lindsay M. Reynolds ◽  
Cristian Zamora ◽  
Un Jung Lee ◽  
Andrew C. Stokes ◽  
Emelia J. Benjamin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Tobacco Use ◽  
The United States ◽  
Tobacco Product ◽  
Self Report ◽  
Cigarette Use ◽  
Data Set ◽  
Factors Associated ◽  
Product Use ◽  
Current Tobacco

Background Although tobacco product use and transitions have been characterized in the general population, few studies have focused on individuals with established cardiovascular disease (CVD) in a population‐based sample. Methods and Results We examined tobacco use prevalence and longitudinal patterns of tobacco product transitions in adults (≥18 years) of the nationally representative PATH (Population Assessment of Tobacco and Health) study, from 2013 to 2014 (Wave 1) through 2016 to 2018 (Wave 4). Prevalent CVD was classified through self‐report of having had a heart attack, heart failure, stroke, or other heart condition. Factors associated with tobacco product use and transitions were investigated using survey logistic regression. We examined 2615 participants with self‐reported CVD at Wave 1. Overall, 28.9% reported current tobacco use, equating to ≈6.2 million adults in the United States with prevalent CVD and current tobacco use. Among adults with CVD who are current tobacco users, the most commonly used product was cigarettes (82.8%), followed by any type of cigar (23.7%), and e‐cigarette use (23.3%). E‐cigarette use without concurrent cigarette use among participants with prevalent CVD was uncommon (1.1%). Factors associated with tobacco use were younger age, male sex, had lower education level, and lack of knowledge about the association between smoking and CVD. Men with prevalent CVD were less likely to use e‐cigarettes compared with women (odds ratio [OR], 0.7; 95% CI, 0.5–0.9). Among cigarette users with CVD, transition rates between Waves 1 and 4 demonstrated <5% decrease in cigarette, with a 0.5% increase in e‐cigarette use. Only ≈10% were in formal tobacco cessation programs. Conclusions Despite known harmful cardiovascular effects, over one fourth of adults with prevalent CVD use tobacco products and few quit smoking over the 4 waves of the PATH data set.

scholarly journals Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015–17)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. L. Chau ◽  
M. P. Wang ◽  
Y. Wu ◽  
D. Y. T. Cheung ◽  
A. Kong ◽  
...  
Keyword(s):  
Control Policy ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Related Factors ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Product Use ◽  
Younger Age ◽  
Current Cigarette ◽  
Age And Sex

Abstract Background Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

scholarly journals Tobacco Use Changes and Perceived Health Risks among Current Tobacco Users during the COVID-19 Pandemic

2021 ◽  
Vol 18 (4) ◽  
pp. 1795
Author(s):  
Jessica M. Yingst ◽  
Nicolle M. Krebs ◽  
Candace R. Bordner ◽  
Andrea L. Hobkirk ◽  
Sophia I. Allen ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Cigarette Use ◽  
User Research ◽  
Convenience Sample ◽  
State College ◽  
Quit Attempt ◽  
Global Pandemic ◽  
Penn State ◽  
Penn State College ◽  
Current Tobacco

COVID-19 has become a global pandemic, with over 81 million cases worldwide. To assess changes in tobacco use as a result of the pandemic, we surveyed a convenience sample of current tobacco users between April and June 2020. The sample was taken from a tobacco user research registry (n = 3396) from the Penn State College of Medicine in Hershey, Pennsylvania, USA. Participants who responded to the survey and were eligible for this study (n = 291) were 25.6% male, 93% white, and had a mean age of 47.3 (SD = 11.6) years. There were no reports of participants testing positive for COVID-19, but 21.7% reported experiencing symptoms associated with the virus. Most participants (67%) believed that their risk of contracting COVID-19 was the same as non-tobacco users, but 57.7% believed that their risk of serious complications, if infected, was greater compared to non-tobacco users. A total of 28% reported increasing their cigarette use during the pandemic. The most common reasons for increased use were increased stress, more time at home, and boredom while quarantined. Nearly 15% reported decreasing their tobacco use. The most common reasons for reduced use were health concerns and more time around non-smokers (including children). A total of 71 (24.5%) users reported making a quit attempt. Characterizing these pandemic-related changes in tobacco use may be important to understanding the full scope of subsequent health outcomes resulting from the pandemic. Tobacco cessation resources should be tailored to allow for safe, appropriate access for those interested in quitting.

scholarly journals Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

2021 ◽  
pp. tobaccocontrol-2021-056528
Author(s):  
Thomas Martinelli ◽  
Math J J M Candel ◽  
Hein de Vries ◽  
Reinskje Talhout ◽  
Vera Knapen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Tobacco Use ◽  
Tobacco Smoking ◽  
Longitudinal Design ◽  
Positive Association ◽  
Cigarette Use ◽  
Convenience Sample ◽  
Frequent Use ◽  
Never Smokers

BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.

scholarly journals Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Rezk-Hanna ◽  
Ian W. Holloway ◽  
Joy Toyama ◽  
Umme Shefa Warda ◽  
Lorree Catherine Berteau ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Study ◽  
Chi Square ◽  
Population Assessment ◽  
Logistic Regression Models ◽  
Global Epidemic ◽  
Product Use ◽  
Hookah Smoking ◽  
Nationally Representative ◽  
And Gender

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. Methods We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013–2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014–2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. Results Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). Conclusions Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.

scholarly journals Polytobacco use among a nationally-representative sample of black high school students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tamika D. Gilreath ◽  
Derek T. Dangerfield ◽  
Francisco A. Montiel Ishino ◽  
Ashley V. Hill ◽  
Renee M. Johnson
Keyword(s):  
High School Students ◽  
Tobacco Use ◽  
Representative Sample ◽  
Latent Class ◽  
Electronic Cigarettes ◽  
Black Adolescents ◽  
Marijuana Use ◽  
Cigarette Use ◽  
Chewing Tobacco ◽  
Targeted Interventions

Abstract Background Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n = 2782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for sex, age, grade, and marijuana use. Results Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR = 24.61, CI = 6.95–87.11). Conclusions Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.

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