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Youth Tobacco Product Use in the United States
Abstract
BACKGROUND: Noncigarette tobacco products are increasingly popular among youth, especially cigarette smokers. Understanding multiple tobacco product use is necessary to assess the effects of tobacco products on population health. This study examines multiple tobacco product use and associated risk factors among US youth. METHODS: Estimates of current use were calculated for cigarettes, cigars, smokeless tobacco, hookah, e-cigarettes, pipes, bidis, kreteks, snus, and dissolvable tobacco by using data from the 2012 National Youth Tobacco Survey (n = 24 658), a nationally representative sample of US middle and high school students. Associations between use patterns and demographic characteristics were examined by using multinomial logistic regression. RESULTS: Among youth, 14.7% currently use 1 or more tobacco products. Of these, 2.8% use cigarettes exclusively, and 4% use 1 noncigarette product exclusively; 2.7% use cigarettes with another product (dual use), and 4.3% use 3 or more products (polytobacco use). Twice as many youth use e-cigarettes alone than dual use with cigarettes. Among smokers, polytobacco use was significantly associated with male gender (adjusted relative risk ratio [aRRR] = 3.71), by using flavored products (aRRR = 6.09), nicotine dependence (aRRR = 1.91), tobacco marketing receptivity (aRRR = 2.52), and perceived prevalence of peer use of tobacco products (aRRR = 3.61, 5.73). CONCLUSIONS: More than twice as many youth in the United States currently use 2 or more tobacco products than cigarettes alone. Continued monitoring of tobacco use patterns is warranted, especially for e-cigarettes. Youth rates of multiple product use involving combustible products underscore needs for research assessing potential harms associated with these patterns.
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“in 2014, twice as many youth used electronic cigarettes alone as in combination with cigarettes.”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [18]
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Metadata
- Authors
- Lee, Y. O., Hebert, C. J., Nonnemaker, J. M., & Kim, A. E.
- Affiliations
- RTI International (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2015-03-01
- Volume
- 135
- Issue
- 3
- Pages
- 409-415
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2088101970
- Cited by
- 168
- References
- 34
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 6 · 2021: 8 · 2020: 54 · 2019: 12 · 2018: 25 · 2017: 16 · 2016: 28 · 2015: 6
- FWCI
- 18.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- 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
- youth tobacco use, polytobacco use, electronic cigarettes, hookah, smokeless tobacco, cigars, bidis, kreteks, snus, flavored tobacco products, nicotine dependence, adolescent smoking, middle and high school students
- MeSH terms
- Adolescent, Child, Female, Humans, Male, Retrospective Studies, Risk Factors, Smoking, Students, Tobacco Use Disorder, United States, Prevalence, Odds Ratio, Tobacco Products, Tobacco Use
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