Who Is Using Alternative Tobacco Products and Why?

Abstract

There is a growing array of alternative tobacco and nicotine products, such as hookah, cigarillos, snus, and electronic nicotine delivery systems (e-cigarettes). Both e-cigarette and hookah use are now more prevalent than cigarette use among adolescents in the United States. Alternative products are appealing to adolescents and young adults because they are available in a variety of flavors, often cheaper than cigarettes, and perceived to be less harmful than cigarettes. Existing studies are beginning to provide important information on the prevalence, correlates, and patterns of alternative tobacco and nicotine product use. Longitudinal models that map developmental trajectories and transitions of tobacco and nicotine use are needed to examine factors associated with persistence, progression, or desistence of use and also with changes in patterns of use. Future research can draw on developmental traditions in other areas of substance use to describe the heterogeneity in product use across time.