Transitions in Tobacco Product Use by U.S. Adults between 2013⁻2014 and 2014⁻2015: Findings from the PATH Study Wave 1 and Wave 2.

Elisabeth A Donaldson ,Liane M Schneller ,Geoffrey T Fong ,Shannon Gravely,Maciej Ł Goniewicz ,David B Abrams ,Yufeng Cheng ,Jennifer Pearson,Eva Sharma,Daniel A Gundersen ,Elizabeth Lambert,Tara Elton‐Marshall ,Dennis R Trinidad ,Maansi Bansal-Travers,K Michael Cummings ,Cassandra A Stanton ,Kevin P Conway ,Nicolette Borek,Blair Coleman,Raymond Niaura,Wilson M Compton ,Iilun Murphy,Karin A Kasza ,Shari P Feirman ,Andrew Hyland

doi:10.3390/ijerph15112515

Abstract

In 2013–2014, nearly 28% of adults in the United States (U.S.) were current tobacco users with cigarettes the most common product used and with nearly 40% of tobacco users using two or more tobacco products. We describe overall change in prevalence of tobacco product use and within-person transitions in tobacco product use in the U.S. between 2013–2014 and 2014–2015 for young adults (18–24 years) and older adults (25+ years). Data from Wave 1 (W1, 2013–2014) and Wave 2 (W2, 2014–2015) of the Population Assessment of Tobacco and Health (PATH) Study were analyzed (N = 34,235). Tobacco product types were categorized into: (1) combustible (cigarettes, cigars, pipe tobacco, hookah), (2) noncombustible (smokeless tobacco, snus pouches, dissolvable tobacco), and (3) electronic nicotine delivery systems (ENDS). Transitions for individual combustible-product types, and for single- and multiple-product use, were also considered. Overall prevalence of current tobacco use decreased from 27.6% to 26.3%. Among W1 non-tobacco users, 88.7% of young adults and 95.8% of older adults were non-tobacco users at W2. Among W1 tobacco users, 71.7% of young adults transitioned, with 20.7% discontinuing use completely, and 45.9% of older adults transitioned, with 12.5% discontinuing use completely. Continuing with/transitioning toward combustible product(s), particularly cigarettes, was more common than continuing with/transitioning toward ENDS. Tobacco use behaviors were less stable among young adults than older adults, likely reflecting greater product experimentation among young adults. Relative stability of cigarette use compared to other tobacco products (except older adult noncombustible use) demonstrates high abuse liability for cigarettes.

Highlights

Cigarette smoking remains the leading cause of preventable death in the world and in the UnitedStates (U.S.), where it is responsible for more than 480,000 deaths each year [1] and annually costs the nation more than USD 300 billion in medical costs [2] and lost productivity due to premature death [1,3]
While the prevalence of cigarette smoking has declined in the U.S [1] and most other high income countries (e.g., Australia, Canada, England, Sweden, and New Zealand) during the past several decades [4], the tobacco product marketplace has expanded in many countries [5], including in the U.S where the prevalence of use of non-cigarette tobacco products, such as electronic nicotine delivery systems (ENDS), cigars, hookah, and smokeless tobacco, has been increasing [6,7,8,9,10,11]
We report national cross-sectional estimates from 34,235 adults (18+ years of age) who participated in Wave 1 (W1, data collection conducted 12 September 2013 through 14 December 2014) or Wave 2 (W2, 23 October 2014 through 30 October 2015) of the Population Assessment of Tobacco and Health (PATH) Study

Summary

Introduction

Cigarette smoking remains the leading cause of preventable death in the world and in the UnitedStates (U.S.), where it is responsible for more than 480,000 deaths each year [1] and annually costs the nation more than USD 300 billion in medical costs [2] and lost productivity due to premature death [1,3]. U.S adults (aged 18+ years) were current users of at least one of the aforementioned tobacco products in 2013–2014, with 18% of adults smoking cigarettes, and nearly 40% of tobacco users using more than one type of tobacco product [12]. While tobacco control policies and regulations vary among countries, an understanding of tobacco product transition behaviors occurring in the U.S. within its current regulatory environment can be informative to other countries, those with expanding tobacco product markets [5]. We report change in the overall prevalence of tobacco product use and within-person transitions in tobacco product use over a one-year period of time in the U.S using a nationally representative sample of young adults (18–24 years of age) and older adults (25 years of age and older)

Methods

Results

Discussion

Conclusion