scholarly journals A comparison of tobacco product prevalence by different frequency of use thresholds across three US surveys

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Luz María Sánchez-Romero ◽  
Christopher J. Cadham ◽  
Jana L. Hirschtick ◽  
Delvon T. Mattingly ◽  
Beomyoung Cho ◽  
...  

Abstract Background With the increasing changes in tobacco use patterns, “current use” definition and the survey used may have important implications for monitoring population use trends. Methods Using three US surveys (2014/15 TUS-CPS, NHIS and PATH), we compared the adult (age 18+) prevalence of four product groups (cigarettes, other combustibles, smokeless tobacco, and e-cigarettes) based on three past 30-day frequency of use thresholds: 1+, 10+, and 25+ days. We also examined mutually exclusive single, dual, and polytobacco users as a percentage of total users for each product group. Results Regardless of threshold or product, the prevalence was higher in PATH followed by NHIS and TUS-CPS, in some cases by large percentages. The differences in cigarette and smokeless tobacco use prevalence in going from the 1+ to 10+ days and to the 25+ days threshold were minimal. Applying different frequency thresholds had the largest impact on other combustibles prevalence, with a 60% reduction with the 10+ days threshold and a 80% reduction with the 25+ days threshold, compared to the 1+ days threshold, followed by e-cigarettes with 40 and 60% reductions, respectively. The proportion of dual and polytobacco users decreased considerably when using the 10+ vs. the 1+ days threshold and polytobacco use was almost non-existent with the 25+ days threshold. Conclusion The estimated prevalence of each tobacco product use depends largely on the survey and frequency of use threshold adopted. The choice of survey and frequency threshold merits serious consideration when monitoring patterns of tobacco use.

2021 ◽  
Author(s):  
Luz María Sánchez-Romero ◽  
Christopher J. Cadham ◽  
Jana L. Hirschtick ◽  
Delvon T. Mattingly ◽  
Beomyoung Cho ◽  
...  

Abstract Background: With the increasing changes in tobacco use patterns, “current use” definition and the survey used may have important implications for monitoring population use trends. Methods: Using three US surveys (2014/15 TUS-CPS, NHIS and PATH), we compared the adult (age 18+) prevalence of four product groups (cigarettes, other combustibles, smokeless tobacco, and e-cigarettes) based on three past 30-day frequency of use thresholds: 1+, 10+, and 25+ days. We also examined mutually exclusive single, dual, and polytobacco users as a percentage of total users for each product group. Results: Regardless of threshold or product, the prevalence was higher in PATH followed by NHIS and TUS-CPS, in some cases by large percentages. The differences in cigarette and smokeless tobacco use prevalence in going from the 1+ to 10+ days and to the 25+ days threshold were minimal. Applying different frequency thresholds had the largest impact on other combustibles prevalence, with a 60% reduction with the 10+ days threshold and a 80% reduction with the 25+ days threshold, compared to the 1+ days threshold, followed by e-cigarettes with 40% and 60% reductions, respectively. The proportion of dual and polytobacco users decreased considerably when using the 10+ vs. the 1+ days threshold and polytobacco use was almost non-existent with the 25+ days threshold. Conclusion: The estimated prevalence of each tobacco product use depends largely on the survey and frequency of use threshold adopted. The choice of survey and frequency threshold merits serious consideration when monitoring patterns of tobacco use.


2020 ◽  
pp. 089011712096406
Author(s):  
Jana L. Hirschtick ◽  
Delvon T. Mattingly ◽  
Beomyoung Cho ◽  
Luis Zavala Arciniega ◽  
David T. Levy ◽  
...  

Purpose: To provide tobacco product use patterns for US adults by sociodemographic group. Design: A secondary analysis of Tobacco Use Supplement to the Current Population Survey (2014-15), National Health Interview Survey (2015), and Population Assessment of Tobacco and Health (2015-16). Setting: United States. Sample: Three nationally representative samples of adults (N = 28,070-155,067). Measures: All possible combinations of cigarette, Electronic Nicotine Delivery Systems (ENDS), other combustible product, and smokeless tobacco use, defined as current use every day or some days. Analysis: Weighted population prevalence and proportion among tobacco users of exclusive, dual, and polyuse patterns by sex, race/ethnicity, education, income, and age. Results: Exclusive cigarette use was the most prevalent pattern (10.9-12.8% of US population). Dual and polyuse were less prevalent at the population level (2.6-5.2% and 0.3-1.3%, respectively) but represented 16.7-25.5% of product use among tobacco users. Cigarette plus ENDS use was similar by sex, but men were more likely to be dual users of cigarettes plus other combustibles or smokeless tobacco. Among race/ethnic subgroups, non-Hispanic (NH) Whites were most likely to use cigarettes plus ENDS, while NH Blacks were most likely to use cigarettes plus other combustibles. Dual and polyuse were generally less common among adults with higher education, income, and age. Conclusion: Differences in product use patterns by sociodemographic group likely represent different risk profiles with important implications for resulting health disparities.


2019 ◽  
Vol 22 (10) ◽  
pp. 1764-1771
Author(s):  
Benjamin W Chaffee ◽  
Peyton Jacob ◽  
Elizabeth T Couch ◽  
Neal L Benowitz

Abstract Introduction Approximately the same percentage of male high school students in the United States currently uses conventional smokeless tobacco as smokes cigarettes, resulting in toxin exposure. Methods This study assessed tobacco product use (smokeless, combustible, and electronic cigarettes) and nicotine and carcinogen exposures in a sample of 594 male rural high school baseball players—a population traditionally at risk for smokeless tobacco use. Salivary specimens were assayed for cotinine (a biomarker of nicotine exposure) and urine specimens for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a biomarker of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) using liquid chromatography–tandem mass spectrometry. Results The prevalence of past 30-day use of any tobacco product was 29%. Past 7-day smokeless tobacco use (prevalence: 13%) was associated with the highest levels of cotinine and NNAL observed in the sample, whether smokeless tobacco was used exclusively (geometric means: cotinine 11.1 ng/mL; NNAL 31.9 pg/mg-creatinine) or in combination with combustible products (geometric means: cotinine 31.6 ng/mL; NNAL 50.0 pg/mg creatinine). Cotinine and NNAL levels were incrementally higher in each increasing category of smokeless tobacco use frequency. However, observed levels were lower than previously reported for adults, likely reflecting less smokeless use per day among adolescents. Conclusions Based on these biomarker observations, adolescents who use conventional smokeless tobacco products are exposed to substantial levels of nicotine and NNK. Although exposed to lower levels than adult smokeless users, the findings are concerning given the young age of the sample and tendency for smokeless tobacco users to increase use intensity over time. Implications This study demonstrates that adolescents using smokeless tobacco are exposed to levels of nicotine and NNK that increase with use frequency and that exceed exposures among peers using other tobacco products. Youth smokeless tobacco use in the United States has not declined along with youth smoking prevalence, giving greater importance to this health concern. To reduce youth (and adult) exposures, needed actions include effective smokeless tobacco use prevention, potentially in combination with reducing the levels of harmful and potentially harmful chemicals in smokeless tobacco products currently popular among adolescents.


Author(s):  
Netri Das ◽  
Anadi S. Tasa ◽  
Anuradha H. Medhi

Background: Tobacco use is a leading cause of preventable death worldwide and an estimated 250 million children and adolescents in developing countries die prematurely because of tobacco consumption. The objectives of the study were to determine the pattern of tobacco use among the adolescents and assess the factors associated with its use in urban slums of Jorhat, Assam.Methods: A community-based cross-sectional study was conducted in two randomly selected urban slums of Jorhat district from September 2015 to February 2016 among 110 adolescents using predesigned pretested proforma. Data were analyzed using SPSS - trial version 16; risk analysis was done using odds ratios with 95% confidence intervals.Results: 106 (96.36%) adolescents had ever used a tobacco product and 97 (88.18%) were current users. 57.73% consumed smokeless form and 3.1% used smoking form exclusively while 39.17% used both smoking and smokeless tobacco. Exclusive smokeless tobacco use was more common among girls. Smoking as well as combined smoking and smokeless tobacco was more common among boys. Gutkha was most common smokeless product (94.84%) and cigarette was commonest smoking form (34.02%) used. Awareness regarding its harmful effects was high (77.28%). Tobacco use in family is significantly associated with current use of tobacco (OR 5.88).Conclusions: Tobacco consumption is an emerging threat to health of adolescents in urban slums. Smokeless tobacco use is high in our study, especially among girls. Tobacco use by family is a major reason behind using tobacco indicating an urgent need to carry out behaviour change communication (BCC) activities among adolescents and their family members. 


2020 ◽  
Author(s):  
Jamie Tam

ABSTRACTIntroductionYouth e-cigarette use has been rising, however U.S. prevalence data are generally reported without disaggregating by individuals’ use of other tobacco products. It is not clear how the proportion of youth e-cigarette users naïve to all combustible tobacco is changing.MethodsAnnual prevalence estimates of ever and current (defined as past 30-day use) tobacco use prevalence by school type are reported using the 2014-2019 National Youth Tobacco Surveys (NYTS) with mutually exclusive categories of e-cigarette, smokeless tobacco, and/or combustible tobacco product use. T-tests were used to compare annual estimates with the preceding year. The annual percent change (APC) for each category from 2014-2018 were analyzed using JoinPoint regression. Data for 2019 were reported separately due to the change in survey format from paper to electronic.ResultsCurrent use of only e-cigarettes among HS students who never used combustible tobacco increased significantly from 2014-2018 (APC = +42.4%, 95% CI: 0.7, 101.3); by 2019, prevalence peaked at 9.2% (95% CI: 8.2, 10.2) among never combustible users and 8.3% (95% CI: 7.3, 9.3) among former combustible users. This coincided with significant declines in use of only combustible tobacco (APC=-14.5%, 95% CI: −18.3, −10.5).ConclusionsUse of only e-cigarettes among US youth with no history of combustible tobacco use has increased substantially over time, even as combustible tobacco use continues to plummet. Of the 17.5% (95% CI: 15.7, 19.0) of HS students who currently used only e-cigarettes (but not other tobacco) in 2019, more than half have no history of combustible tobacco use.


1988 ◽  
Vol 13 (2) ◽  
pp. 219-223 ◽  
Author(s):  
Elizabeth W. Edmundson ◽  
Elbert D. Glover ◽  
Don Holbert ◽  
Paul P. Alston ◽  
Kathleen L. Schroeder

Author(s):  
Allison M Glasser ◽  
Amanda L Johnson ◽  
Raymond S Niaura ◽  
David B Abrams ◽  
Jennifer L Pearson

Abstract Introduction According to the National Youth Tobacco Survey (NYTS), youth e-cigarette use (vaping) rose between 2017 and 2018. Frequency of vaping and concurrent past 30-day (p30d) use of e-cigarettes and tobacco products have not been reported. Methods We analyzed the 2018 NYTS (N = 20 189) for vaping among all students (middle and high school; 6–12th grades; 9–19 years old) by frequency of vaping, exclusive vaping, p30d poly-product use (vaping and use of one or more tobacco product), and any past tobacco product use. Results In 2018, 81.4% of students had not used any tobacco or vapor product in the p30d, and 86.2% had not vaped in the p30d. Among all students, of the 13.8% vaped in the p30d, just over half vaped on ≤5 days (7.0%), and roughly a quarter each vaped on 6–19 days (3.2%) and on 20+ days (3.6%). Almost three quarters of p30d vapers (9.9%) reported past or concurrent tobacco use and the remainder (3.9%) were tobacco naïve. 2.8% of students were tobacco naïve and vaped on ≤5 days; 0.7% were tobacco-naïve and vaped on 6–19 days, and 0.4% were tobacco-naïve and vaped on 20+ days. Conclusions Vaping increased among US youth in 2018 over 2017. The increases are characterized by patterns of low p30d vaping frequency and high poly-product use, and a low prevalence of vaping among more frequent but tobacco naïve vapers. Implications Results underscore the importance of including the full context of use patterns. The majority of vapers (60.0%–88.9% by use frequency) were concurrent p30d or ever tobacco users. About 4% of students were tobacco naïve and vaped in the p30d, but few (0.4%) vaped regularly on 20 or more days. Reporting youth vaping data with frequency and tobacco product co-use will give public health decision-makers the best possible information to protect public health.


2020 ◽  
Vol 22 (10) ◽  
pp. 1901-1908 ◽  
Author(s):  
Ralitza Gueorguieva ◽  
Eugenia Buta ◽  
Patricia Simon ◽  
Suchitra Krishnan-Sarin ◽  
Stephanie S O’Malley

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.


Addiction ◽  
2003 ◽  
Vol 98 (8) ◽  
pp. 1077-1085 ◽  
Author(s):  
Lynn T. Kozlowski ◽  
Richard J. O'Connor ◽  
Beth Quinio Edwards ◽  
Brian P. Flaherty

2021 ◽  
Author(s):  
Allison M. Glasser ◽  
Alice Hinton ◽  
Amy Wermert ◽  
Joseph Macisco ◽  
Julianna Nemeth

Abstract BackgroundCigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among homeless young people in a Midwestern city.MethodsThis study included 96 youth and young adults (52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana and other product use characteristics (e.g., frequency, brand and flavor).ResultsMost youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (88.5%), cigars (92.7%), and marijuana (85.4%) in the past month. One-third used electronic vapor products, 19.8% smoked hookah, and 11.5% used smokeless tobacco. Most marijuana users co-administered with tobacco (69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one’s housing situation. Newport and Black & Mild were the most popular brands of cigarettes and cigars. Most non-combustible tobacco users reported not having a usual brand. Cigar smokers reported the most varied selection of flavors.ConclusionsYoung combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support cessation in this population.


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