Abstract
AimsThis paper explores inter-generational changes in consumers smoking product uptake and use patterns after the introduction of e-cigarettes and hookahs. DesignItem Response Theory (IRT) is used to analyze the Health Information National Trends Survey sponsored by the Food and Drug Administration (HINTS-FDA). The survey was fielded in 2015. IRT allows the pattern of product use to be described and help assess whether the new tobacco products (i.e., e-cigarettes, hookahs) serve as gateway to other products or act in harm reduction modality. FindingsThe results indicate that the new product alternatives have changed the how tobacco products are adopted in the U.S. In particular, younger respondents were more likely to have engaged in cigar, e-cigarette and water-pipe use than the older cohort. ConclusionsThe introduction of nicotine products previously unavailable in the U.S is creating new modes for smoking initiation in the age groups most likely to begin a new habit. There is little evidence that smokers in the older HINTS cohorts are using the e-cigarette as a smoking cessation tool. The rise of cigar use in the younger cohort may indicate that legal products are being mixed with illicit substances (i.e., ‘blunting’).
Highlights
Tobacco use is the largest cause of preventable disease and death in the U.S (Dietz, Douglas, & Brownson, 2016)
Water pipes and electronic nicotine delivery systems’ (ENDS) represent two relatively new products in the U.S marketplace and they are increasing in popularity among young consumers (Huerta et al, 2016)
While the water pipe or hookah is an older technology imported into the U.S from the Middle East and North Africa, it has seen a significant increase in its popularity in recent years
Summary
Tobacco use is the largest cause of preventable disease and death in the U.S (Dietz, Douglas, & Brownson, 2016). The net effect has been an overall reduction in the number of habitual tobacco users and a reduced rate of those initiating the practice Within this context, new and old technologies that deliver tobacco’s addictive chemical – nicotine – have been introduced into the U.S marketplace. The American Lung Association reports that young adults (ages 18–24) are the consumers targeted by these products’ ads because they are three times more likely to initiate ENDS use than traditional cigarettes Both products, hookah and ENDS gained their marketplace footholds without relying on traditional retail outlets (e.g., convenience stores). Water-pipe smoking typically takes place in dedicated ‘hookah bars’ or cafes that sell other smoking paraphernalia In this sense, hookah use represents a group-driven form of hedonic pleasure. The group nature of the activity makes it more likely that younger consumers, who identify strongly with peers engaged in the smoking ritual will partake despite the moral ambiguity of such consumption (Von Schuckmann, Barros, Dias, & Andrade, 2018)
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