Dataset Information

Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health.

ABSTRACT:

Objectives

The purpose of this study is to evaluate and describe transitions in cigarette and smokeless tobacco (ST) use, including dual use, prospectively from adolescence into young adulthood.

Methods

The current study utilizes four waves of the National Longitudinal Study of Adolescent Health (Add Health) to examine patterns of cigarette and ST use (within 30 days of survey) over time among a cohort in the United States beginning in 7th-12th grade (1995) into young adulthood (2008-2009). Transition probabilities were estimated using Markov modeling.

Results

Among the cohort (N=20,774), 48.7% reported using cigarettes, 12.8% reported using ST, and 7.2% reported dual use (cigarettes and ST in the same wave) in at least one wave. In general, the risk for transitioning between cigarettes and ST was higher for males and those who were older. Dual users exhibited a high probability (81%) of continuing dual use over time.

Conclusions

Findings suggest that adolescents who use multiple tobacco products are likely to continue such use as they move into young adulthood. When addressing tobacco use among adolescents and young adults, multiple forms of tobacco use should be considered.

SUBMITTER: Kaufman AR

PROVIDER: S-EPMC4679648 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health.

Kaufman Annette R AR Land Stephanie S Parascandola Mark M Augustson Erik E Backinger Cathy L CL

Preventive medicine 20150909

<h4>Objectives</h4>The purpose of this study is to evaluate and describe transitions in cigarette and smokeless tobacco (ST) use, including dual use, prospectively from adolescence into young adulthood.<h4>Methods</h4>The current study utilizes four waves of the National Longitudinal Study of Adolescent Health (Add Health) to examine patterns of cigarette and ST use (within 30 days of survey) over time among a cohort in the United States beginning in 7th-12th grade (1995) into young adulthood (2 ...[more]

PMID: 26361752

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Project description:AimsThis study aims to identify adolescent patterns of polytobacco use and measure transitions between patterns over time.DesignLongitudinal analysis using data derived from waves 1-4 (2013-18) of the Population Assessment of Tobacco and Health (PATH) study. Transitions in tobacco use patterns were examined via latent transition analysis, and then, socio-demographic characteristics were used to predict transitions via logistic regression.SettingUnited States.ParticipantsParticipants included 975 adolescents who used at least one tobacco product at any wave (W1 mean age = 13.29, standard deviation = 0.86; W4 54.2% male; 54.5% white, 25.9% Hispanic).MeasurementsMeasurements included past 30-day use of cigarettes, electronic cigarettes (e-cigs), traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco (SLT) or hookah.FindingsSix latent classes were identified. Cigarette users (43.5-58.8%) and SLT users (50.8-79.6%) tended to persist in their use over time. E-cig users began to probably transition to non-users (80.0%), but became more likely to persist in this use over time (31.1%). Non-users at a given wave were most likely to transition to e-cig users (8.5-43.7%) or cigarette users (6.7-28.6%). Cigarillo/poly-users and hookah/poly-users displayed more variable transition patterns. Adolescents were more likely to transition to non-use (versus become/remain e-cig users) if they were older (cigarette users, SLT users), younger (e-cig users), other race (SLT users), male (SLT users) or had less-educated parents (SLT users) compared with their counterparts. Hispanic (versus white) cigarette users were more likely to transition to non-users than to persist in this use.ConclusionsAmong adolescents in the United States, patterns of tobacco use characterized by the use, mainly, of single, specific products appear to be stable, particularly by late adolescence. In contrast, patterns characterized by polytobacco use appear to be more variable and may represent experimentation without specialization.

Project description:IntroductionSmokeless tobacco (SLT) use in the United States has remained constant or even increased slightly in recent years, whereas smoking has continuously decreased. Characterization of transitions between tobacco products is critical to understand the reasons behind the continuing use of smokeless tobacco.MethodsTwo longitudinal cohorts of Tobacco Use Supplement of the Current Population Survey (TUS-CPS), 2002-2003 (n = 14996) and 2010-2011 (n = 18226), were used to examine transitions between cigarette and SLT use over 1-year periods. Weighted population percentages of four use categories (exclusive cigarette use, exclusive SLT use, dual use, and neither) were calculated for different demographic groups. Transition between use categories and quit rates by product were calculated for each cohort.ResultsRelative to 2002-2003, smoking quit rates of male exclusive smokers significantly increased in 2010-2011 (11.6% vs. 24.4%, p < .0001), but the corresponding SLT use quit rates remained stable (41.3% vs. 40.0%, p = .87). Similar patterns were found in females with smoking quit rates increasing considerably (12.3% vs. 24.2%, p < .0001). Smoking quit rates increased in most sociodemographic groups analyzed. Male SLT use quit rates were significantly lower in SLT exclusive users than in dual users in the 2010-2011 cohort (40.0% vs. 62.2%; p = .04), but smoking quit rates in exclusive smokers and in dual users were roughly equivalent (24.4% vs. 29.5%, p = .68).ConclusionsAlthough smoking quit rates doubled overall and increased in most sociodemographic groups, SLT quit rates remained constant with little transition between products. Longer-term prospective data examining polytobacco use are needed to better understand transitions between tobacco products.ImplicationsThis study uses two longitudinal surveys to investigate changes in switching behaviors between tobacco products. We found that quit rates of self-reported smoking doubled between 2002-2003 and 2010-2011 in most sociodemographic groups in the United States, whereas in contrast quit rates of self-reported Smokeless Tobacco (SLT) use remained roughly constant. This explains in part the opposing trends of tobacco use by product in the United States, with smoking continuing its decrease, whereas SLT use remains constant. Moreover, smokers were unlikely to switch to other forms of tobacco compared to SLT users. Lastly, smoking cessation for dual users was not significantly different from that of exclusive smokers. Understanding transitions between smoking and SLT use is critical to assess the potential long-term impact of SLT use, and potentially that of other alternative tobacco products, on tobacco-related health outcomes.

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Dataset Information

Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health.

Objectives

Methods

Results

Conclusions

Publications

Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health.

Similar Datasets

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