Cited by 872Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesGlobal Public Health Policies and Epidemiology

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Design and methods of the Population Assessment of Tobacco and Health (PATH) Study

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Hyland, Andrew, Ambrose, Bridget K, Conway, Kevin P, Borek, Nicolette, Lambert, Elizabeth, Carusi, Charles, Taylor, Kristie, Crosse, Scott, Fong, Geoffrey T, Cummings, K Michael, Abrams, David, Pierce, John P, Sargent, James, Messer, Karen, Bansal-Travers, Maansi, Niaura, Ray, Vallone, Donna, Hammond, David, Hilmi, Nahla, Kwan, Jonathan, Piesse, Andrea, Kalton, Graham, Lohr, Sharon, Pharris-Ciurej, Nick, Castleman, Victoria, Green, Victoria R, Tessman, Greta, Kaufman, Annette, Lawrence, Charles, van Bemmel, Dana M, Kimmel, Heather L, Blount, Ben, Yang, Ling, O'Brien, Barbara, Tworek, Cindy, Alberding, Derek, Hull, Lynn C, Cheng, Yu-Ching, Maklan, David, Backinger, Cathy L, Compton, Wilson M·2017·Tobacco Control

DOI 10.1136/tobaccocontrol-2016-052934PMC PMC5299069

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Abstract

BACKGROUND: This paper describes the methods and conceptual framework for Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study data collection. The National Institutes of Health, through the National Institute on Drug Abuse, is partnering with the Food and Drug Administration's (FDA) Center for Tobacco Products to conduct the PATH Study under a contract with Westat. METHODS: The PATH Study is a nationally representative, longitudinal cohort study of 45 971 adults and youth in the USA, aged 12 years and older. Wave 1 was conducted from 12 September 2013 to 15 December 2014 using Audio Computer-Assisted Self-Interviewing to collect information on tobacco-use patterns, risk perceptions and attitudes towards current and newly emerging tobacco products, tobacco initiation, cessation, relapse behaviours and health outcomes. The PATH Study's design allows for the longitudinal assessment of patterns of use of a spectrum of tobacco products, including initiation, cessation, relapse and transitions between products, as well as factors associated with use patterns. Additionally, the PATH Study collects biospecimens from consenting adults aged 18 years and older and measures biomarkers of exposure and potential harm related to tobacco use. CONCLUSIONS: The cumulative, population-based data generated over time by the PATH Study will contribute to the evidence base to inform FDA's regulatory mission under the Family Smoking Prevention and Tobacco Control Act and efforts to reduce the Nation's burden of tobacco-related death and disease.

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Self-citation
Cumulative cigarette discount coupon exposure and trajectories of cigarette smoking: a longitudinal analysis in US adults
Hamilton-Moseley, K. R., McNeel, T., & Choi, K. (2023) · Tobacco Control · doi:10.1136/tc-2022-057801 · Cited by 7
Assessment of Electronic Nicotine Delivery Systems With Cigarette Use and Self-reported Wheezing in the US Adult Population
Sánchez-Romero, L., Bondarenko, I., Knoll, M., Hirschtick, J. L., Cook, S., Fleischer, N., & Levy, D. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.6247 · Cited by 7
Association between family or peer views towards tobacco use and past 30-day smoking cessation among adults with mental health problems
Nagawa, C. S., Pbert, L., Wang, B., Cutrona, S., Davis, M., Lemon, S., & Sadasivam, R. (2022) · Preventive medicine reports · doi:10.1016/j.pmedr.2022.101886 · Cited by 7
Intentions and Attempts to Quit Smoking Among Sexual Minoritized Adult Smokers After Exposure to the Tips From Former Smokers Campaign
Wang, Y., Duan, Z., Emery, S., Weaver, S. R., Self‐Brown, S., Ashley, D. L., & Huang, J. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.11060 · Cited by 10
Association between Inclusion of E-Cigarettes in Statewide Comprehensive Smoke-Free Indoor Air Laws and Vaping Behaviors: Results from a Longitudinal Population Study
Yang, M., Russell, A. M., & Lin, H.-C. (2022) · Substance Use & Misuse · doi:10.1080/10826084.2022.2046091 · Cited by 7
Factors associated with changes in flavored tobacco products used: Findings from wave 2 and wave 3 (2014–2016) of the population assessment of tobacco and health (PATH) study
Bansal-Travers, M., Rivard, C., Silveira, M., Kimmel, H., Poonai, K., Bernat, J. K., Jackson, K., Rudy, S., Johnson, A. L., Cullen, K. A., et al. (2022) · Addictive Behaviours · doi:10.1016/j.addbeh.2022.107290 · Cited by 7
“(Hyland et al., 2017) Details on interview procedures, questionnaires, sampling, response rates, weighting, and accessing the data are available at https://doi.”
MethodSelf-citation
Risk perceptions and continued smoking as a function of cigarette filter ventilation level among U.S. youth and young adults who smoke
Carroll, D., Tessier, K. M., Cummings, K., O'Connor, R., Reisinger, S., Shields, P., Stepanov, I., Luo, X.-H., Hatsukami, D., & Rees, V. (2021) · Tobacco Control · doi:10.1136/tobaccocontrol-2021-056833 · Cited by 7
Self-citation
Women with Adverse Pregnancy Outcomes Have Higher Odds of Midlife Stroke: The Population Assessment of Tobacco and Health Study
Miller, E. C., Bello, N. A., Davis, R., Friedman, A. M., Elkind, M. S. V., Wapner, R. J., & Tom, S. E. (2021) · Journal of Women s Health · doi:10.1089/jwh.2021.0184 · Cited by 8
Price promotion receipt and use progression of any tobacco, cigarettes, e-cigarettes and cigars among US youth between 2016 and 2018
Chen-Sankey, J. C., Unger, J. B., Bernat, E. M., Niederdeppe, J., Bansal‐Travers, M., & Choi, K. (2021) · Tobacco Control · doi:10.1136/tobaccocontrol-2021-056667 · Cited by 10
Self-citation
Associations between Black and Mild Cigar Pack Size and Demographics and Tobacco Use Behaviors among US Adults
Ganz, O., King, J. L., Giovenco, D. P., Hrywna, M., Strasser, A. A., & Delnevo, C. D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18126628 · Cited by 9
“Details on sample design can be found elsewhere [41,42].”
BackgroundMethod
Prospective estimation of the age of initiation of cigarettes among young adults (18–24 years old): Findings from the Population Assessment of Tobacco and Health (PATH) waves 1–4 (2013–2017)
Pérez, A., Kuk, A. E., Bluestein, M. A., Penedo, E., Nhpang, R., Chen, B., Perry, C. L., Sterling, K. L., & Harrell, M. B. (2021) · PLoS ONE · doi:10.1371/journal.pone.0251246 · Cited by 10
“In addition, all data were de-identified in order to preserve participant anonymity [23].”
BackgroundMethodInfluential
Variations in Electronic Nicotine Delivery System (ENDS) Device Types and Association with Cigarette Quit Attempts
Sharma, E., Yang, D.-H., & Stroud, L. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106588 · Cited by 7
A prospective study of the association between rate of nicotine metabolism and alcohol use in tobacco users in the United States
Roberts, W., Marotta, P., Verplaetse, T., Peltier, M., Burke, C., Ramchandani, V., & McKee, S. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.108210 · Cited by 7
Profiles of Nicotine and Cannabis Exposure among Young Adults with Asthma
Clawson, A. H., Ruppe, N. M., Nwankwo, C. N., & Blair, A. L. (2020) · Behavioral Medicine · doi:10.1080/08964289.2020.1763904 · Cited by 7
“These questions were consistent with standardized questions used in a nationally-funded study and prior literature.(42)”
Method
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.
Zarndt, A. N., Donaldson, E. A., Bernat, J. K., Henrie, J., & Portnoy, D. B. (2019) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntz215 · Cited by 7
Exposure to a Tobacco-Specific Carcinogen Among Adolescent Smokeless Tobacco Users in Rural California, United States.
Chaffee, B., Jacob, P., Couch, E. T., & Benowitz, N. (2019) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntz147 · Cited by 7
Combustible cigarette smoking and alternative tobacco use in a sample of youth transitioning from foster care
Braciszewski, J. M., Vose-O’Neal, A., Gamarel, K. E., & Colby, S. M. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.11.054 · Cited by 7
“Our survey was broken up into several distinct sections and was adapted from the Population Assessment of Tobacco and Health (PATH) Baseline Survey (Hyland et al., 2016).”
MethodInfluential
Bidirectional relationships between pain and patterns of cannabis and tobacco use in a US nationally representative sample
Rubenstein, D., Green, M. J., Sweitzer, M., Keefe, F., & McClernon, F. (2024) · Pain · doi:10.1097/j.pain.0000000000003381 · Cited by 6
Longitudinal associations between exclusive, dual and polytobacco use and respiratory illness among youth
Arciniega, L. Z., Cook, S., Hirschtick, J. L., Xie, Y., Mukerjee, R., Arenberg, D. A., Barnes, G. D., Levy, D. T., Meza, R., & Fleischer, N. L. (2024) · BMC Public Health · doi:10.1186/s12889-024-19582-8 · Cited by 8
“A detailed description of the methodology of the PATH study has been published else-where [24, 25].”
Method
Patterns of poly tobacco use among adults in the Population Assessment of Tobacco and Health (PATH) study, 2013–2017: a multistate Markov transition analysis
Khorassani, F. S., Brouwer, A., Hirschtick, J. L., Jeon, J., Jimenez-Mendoza, E., Meza, R., & Fleischer, N. (2023) · Tobacco Control · doi:10.1136/tc-2022-057822 · Cited by 6
“For each univariable multistate”
Background
Response to health warnings on cigarette packs as a predictor of future smoking among current tobacco smokers.
Cannoy, C. N., Bauer, S., Prakash, K., Excell, S., Ghosh, S., Lundahl, L. H., & Ledgerwood, D. M. (2023) · Addictive Behaviours · doi:10.1016/j.addbeh.2023.107717 · Cited by 6
Binary classification of users of electronic cigarettes and smokeless tobacco through biomarkers to assess similarity with current and former smokers: machine learning applied to the population assessment of tobacco and health study
Ohara, H., Ito, S., & Takanami, Y. (2023) · BMC Public Health · doi:10.1186/s12889-023-15511-3 · Cited by 8
“The detailed study design and data collection of the PATH study have previously been published [17].”
Background
Biochemical Validation of Dependence on JUUL and Other E-Cigarettes Among Youth.
Pierce, J., Leas, E., & Strong, D. (2023) · Pediatrics · doi:10.1542/peds.2022-059158 · Cited by 6
Self-citation
Shifts in preference for Natural American Spirit and associated belief that one’s own cigarette brand might be less harmful than other brands: results from Waves 1–4 of the Population Assessment of Tobacco and Health (PATH) Study (2013–2018)
Pearson, J. L., Ganz, O., Ohman-Strickland, P., & Wackowski, O. (2021) · Tobacco Control · doi:10.1136/tobaccocontrol-2021-056985 · Cited by 6
Beliefs About the Health Effects of Smoking Among Adults in the United States
Mills, S. D., & Wiesen, C. (2021) · Health Education & Behavior · doi:10.1177/10901981211004136 · Cited by 6
“Relationships between sex and race/ethnicity and health beliefs have been inconsistent, with studies finding nonsignificant and significant relationships (Brownson et al., 1992; Klesges et al., 1988; Rutten et al., 2008).”
BackgroundResult
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
Rezk-Hanna, M., Holloway, I., Toyama, J., Warda, U., Berteau, L. C., Brecht, M., & Sarna, L. (2021) · BMC Public Health · doi:10.1186/s12889-021-10389-5 · Cited by 6
Age of Onset of Susceptibility to Different Tobacco Products Among Non-Susceptible US Young Adults: Findings from the Population Assessment of Tobacco and Health Study Waves 2-4 (2014-2017)
Pérez, A., Bluestein, M. A., Kuk, A. E., Chen, B., Sterling, K. L., & Harrell, M. B. (2021) · Tobacco Use Insights · doi:10.1177/1179173x211065643 · Cited by 10
“Further details on the PATH study design have been previously described.(35) Secondary analyses of young adult participants (18-24 years old) who were never users of each tobacco product and non-susceptible to use at wave 2 (when susceptibility questions were first asked among young adults) or wave 3 (among “aged-up”…”
MethodInfluential
Multi-directional pathways of tobacco and marijuana use, including comorbid use, among a population-based cohort of adolescents in Texas: A six-wave cross-lagged model
Rogers, S. M., Harrell, M. B., Chen, B., Springer, A. E., Loukas, A., & Perry, C. L. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2020.106771 · Cited by 7
Adults’ E-Cigarette Flavor Use and Cigarette Quit Attempts: Population Assessment of Tobacco and Health (PATH) Study Findings
Kasza, K., Edwards, K. C., Gravely, S., Coleman, B., Kimmel, H., Everard, C., Goniewicz, M., Fong, G., & Hyland, A. (2020) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2020.06.017 · Cited by 6
Self-citation
Cigarette smoking and E-cigarette use among young adults in the United States: Findings from the 2016-18 behavioral risk factor surveillance system.
Gagné, T., Lee, J. G. L., & O'Loughlin, J. (2020) · Addictive Behaviours · doi:10.1016/j.addbeh.2020.106675 · Cited by 6
Multidirectional Pathways of Tobacco and Marijuana Use, Including Comorbid Use, Among Young Adults (Aged 18–25 Years) in Texas: A Six-Wave Cross-Lagged Model
Rogers, S. M., Loukas, A., Harrell, M. B., Chen, B., Springer, A. E., & Perry, C. L. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2020.05.028 · Cited by 6
Cigarette consumption in adult dual users of cigarettes and e-cigarettes: a review of the evidence, including new results from the PATH study
Lee, P. N., Fry, J. S., Forey, B. A., Coombs, K. J., & Thornton, A. J. (2020) · F1000Research · doi:10.12688/f1000research.24589.1 · Cited by 6
“We derive answers to the three questions from Waves 1, 2 and 3 of the publicly available adult data from the Population Assessment of Tobacco and Health (PATH) study (Hyland et al., 2017), a longitudinal cohort study in the U.”
Method
“I quit”: Testing the added value and sequencing effects of an efficacy-focused message among cigarette warning labels
Jesch, E., Niederdeppe, J., King, A. J., Safi, A. G., & Byrne, S. (2020) · Journal of health communication · doi:10.1080/10810730.2020.1767236 · Cited by 6
E-cigarette Use Is Associated with Non-prescribed Medication Use in Adults: Results from the PATH Survey
Bentivegna, K., Atuegwu, N., Oncken, C., Mead, E., Perez, M. F., & Mortensen, E. (2019) · Journal of general internal medicine · doi:10.1007/s11606-019-05093-5 · Cited by 6
The Relationship Between Neighborhood Disorder and Barriers to Cessation in a Sample of Impoverished Inner-City Smokers in Baltimore, Maryland, United States
Latkin, C., Kennedy, R., Davey-Rothwell, M., Tseng, T.-Y., Czaplicki, L., Baddela, A., Edwards, C., Chander, G., Moran, M., & Knowlton, A. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntx252 · Cited by 6
Reasons for Young Adult Waterpipe Use in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study.
Silveira, M., Hilmi, N., & Conway, K. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.06.004 · Cited by 6
Self-citation
Patterns of e-cigarette use and self-reported health outcomes among smokers and non-smokers in the United States: A preliminary assessment
Chang, Y.-C., Lee, Y.-H., Liu, C.-T., & Shelley, M. (2018) · Journal of Substance Use · doi:10.1080/14659891.2018.1510053 · Cited by 6
Time-Specific Predictors of E-Cigarette and Cigarette Use Trajectory Classes From Preadolescence to Late Adolescence (2013-2020) of the Population Assessment of Tobacco and Health (PATH) Study.
Stanton, C. A., Tang, Z.-Q., Sharma, E., Salim, A. H., Creamer, M. R., Ruybal, A. L., Marshall, D., Zaganjor, I., Silveira, M., Rivers, D. L., et al. (2025) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2025.03.010 · Cited by 5
Self-citation
Attention-Deficit/Hyperactivity Disorder Symptoms and Later E-Cigarette and Tobacco Use in US Youths
McCabe, S., Pasman, E., Wilens, T. E., Boyd, C., Veliz, P., McCabe, V. V., Chen, B.-M., Dickinson, K., & Evans-Polce, R. J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.58834 · Cited by 5
Social Epidemiology of Dual Use of Electronic and Combustible Cigarettes Among U.S. Adults: Insights from the Population Assessment of Tobacco and Health (PATH) Study
Assari, S., & Sheikhattari, P. (2024) · Global journal of cardiovascular diseases · doi:10.31586/gjcd.2024.1131 · Cited by 5
“This study employed cross-sectional data from the Population Assessment of Tobacco and Health (PATH) Study [16,17] wave 1.”
Association between tobacco product use and respiratory health and asthma-related interference with activities among U.S. Adolescents
Yao, T., Watkins, S. L., Sung, H., Wang, Y., Gu, D., Lyu, J. C., Lightwood, J. M., & Max, W. B. (2024) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2024.102712 · Cited by 8
“Using a multistage and stratified sampling design (Hyland et al., 2017), the survey collected respondents ’ information on tobacco product use, health conditions, and other individual-level characteristics using computer-assisted interviewing at home.”
Method
Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates
Romm, K. F., Berg, C. J., Wang, Y., & Cohn, A. M. (2024) · Substance use & addiction journal · doi:10.1177/29767342231222245 · Cited by 5
Factors Associated With the Changes in Smoking and Electronic cigarette use in Adolescents During the COVID-19 Pandemic: A Longitudinal Analysis
Vidaña‐Pérez, D., Mus, S., Monzon, J. C., Dávila, G., Fahsen, N., Barnoya, J., & Thrasher, J. F. (2024) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2023.11.399 · Cited by 5
Racial and Ethnic Disparities in Mental Health Problems and Tobacco and Cannabis Use Among US Emerging Adults
Mattingly, D. T., Mezuk, B. R., Elliott, M. R., Neighbors, H. W., & Fleischer, N. L. (2023) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-023-01822-z · Cited by 3
The interaction of e‐cigarette use and mental health symptoms on risk of cigarette smoking initiation among young adults in the United States
Harlow, A. F., Han, D., Eckel, S. P., McConnell, R., Leventhal, A. M., & Barrington‐Trimis, J. L. (2023) · Addiction · doi:10.1111/add.16319 · Cited by 7
Longitudinal relationship between relative harm perceptions, beliefs about organic and additive-free tobacco, and cigarette brand switching among Natural American Spirit, Camel, and Marlboro cigarette smokers
Pearson, J. L., Gratale, S., Ganz, O., Erinoso, O., Ohman-Strickland, P., & Wackowski, O. (2023) · Tobacco Control · doi:10.1136/tc-2023-057933 · Cited by 5

Authors: Hyland, A., Ambrose, B. K., Conway, K. P., Borek, N., Lambert, E., Carusi, C., Taylor, K., Crosse, S., Fong, G. T., Cummings, K. M., Abrams, D., Pierce, J. P., Sargent, J., Messer, K., Bansal-Travers, M., Niaura, R., Vallone, D., Hammond, D., Hilmi, N., Kwan, J., Piesse, A., Kalton, G., Lohr, S., Pharris-Ciurej, N., Castleman, V., Green, V. R., Tessman, G., Kaufman, A., Lawrence, C., van Bemmel, D. M., Kimmel, H. L., Blount, B., Yang, L., O'Brien, B., Tworek, C., Alberding, D., Hull, L. C., Cheng, Y.-C., Maklan, D., Backinger, C. L., & Compton, W. M.
Affiliations: Roswell Park Comprehensive Cancer Center (US)
United States Food and Drug Administration (US)
National Institutes of Health (US)
Westat (United States) (US)
Ontario Institute for Cancer Research (CA)
Medical University of South Carolina (US)
Truth Initiative (US)
University of California San Diego (US)
Dartmouth College (US)
Centers for Disease Control and Prevention (US)
Corresponding author: Hyland, Andrew
ORCID: Hyland, Andrew
Ambrose, Bridget K
Conway, Kevin P
Carusi, Charles
Taylor, Kristie
Fong, Geoffrey T
Cummings, K Michael
Abrams, David
Pierce, John P
Sargent, James
Messer, Karen
Vallone, Donna
Hammond, David
Kwan, Jonathan
Piesse, Andrea
Kalton, Graham
Lohr, Sharon
Kaufman, Annette
Lawrence, Charles
van Bemmel, Dana M
Kimmel, Heather L
Yang, Ling
Cheng, Yu-Ching
Compton, Wilson M
Venue: Tobacco Control
Publisher: BMJ
Published: 2016-08-08
Volume: 26
Issue: 4
Pages: 371-378
ISSN: 0964-4563 (ISSN-L)
1468-3318
DOI: 10.1136/tobaccocontrol-2016-052934
PMC: PMC5299069
OpenAlex: W2518934199
Cited by: 872
References: 45
Citations by year: 2026: 55 · 2025: 74 · 2024: 101 · 2023: 103 · 2022: 116 · 2021: 105 · 2020: 115 · 2019: 94 · 2018: 69 · 2017: 36 · 2016: 3
FWCI: 54.22
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Tobacco Control (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: U.S. Department of Health and Human Services (HHSN271201100027 C)
National Institutes of Health (Contract No. HHSN271201100027C, HHSN271201100027C)
Centers for Disease Control and Prevention
National Institute on Drug Abuse (HHSN271201100027C)
National Cancer Institute (P30CA023100, P30CA023108)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
Keywords: tobacco use patterns, tobacco initiation, tobacco cessation, relapse, risk perception, biological specimen, biomarkers of tobacco exposure, longitudinal cohort, audio computer-assisted self-interviewing, Family Smoking Prevention and Tobacco Control Act, tobacco regulation
MeSH terms: Adolescent, Adult, Aged, Child, Female, Humans, Health Knowledge, Attitudes, Practice, Longitudinal Studies, Male, Middle Aged, Public Health, Research Design, Smoking, United States, Young Adult

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