Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study

Abstract

The purpose of this study was to investigate susceptibility and ever use of tobacco products among adolescents and young adults in the US. Cross-sectional analysis of Wave 1(2013-2014) adolescent (12-17year-olds; n=13,651) and young adult (18-24year-olds; n=9112) data from the nationally-representative Population Assessment of Tobacco and Health (PATH) Study was conducted. At 12years, 5% were ever tobacco users and 36% were susceptible to use. Seventy percent were susceptible at age 17years, and the same proportion were ever users at age 22years. Susceptibility levels were comparable for cigarettes and e-cigarette (28.6% and 27.4%, respectively), followed by hookah (22.0%), pipes (17.5%), cigars (15.2%), and smokeless tobacco (9.7%). Non-Hispanic (NH) Black (Adjusted Odds Ratio [ORadj]=1.36; 95% Confidence Limit [CL], 1.18-1.56) and Hispanic (ORadj=1.34: 95% CL,1.19-1.49) adolescent never- users were more likely to be susceptible to future use of a tobacco product than NH Whites. Susceptibility was higher with age (15-17yrs. vs 12-14yrs.: OR_adj=1.69; 95% CL, 1.55-1.85) and parental education (college graduates vs less than HS education: OR_adj=1.22, 95% CL, 1.08-1.39). Compared to exclusive users of hookah, cigars, or smokeless products, larger proportions of exclusive e-cigarette ever users were also susceptible to cigarette use. Among adolescents, lower levels of ever use of tobacco products are often counterbalanced by higher levels of susceptibility for future use, which may suggest delayed initiation in some groups. Ever users of a given tobacco product were more susceptible to use other tobacco products, putting them at risk for future multiple tobacco product use.

Keywords: Susceptibility; Tobacco products; Youth and young adults.

Figure 1. Percent of Adolescents (12–17 years; 13 651) At Risk* (Susceptible and Ever Use**) for Tobacco Products by Race/Ethnicity Group

* TOTAL at risk for use as adults = sum of susceptible never tobacco users, non-current ever users and current users **Ever used includes current users (within past 30 days) and non-current ever users (prior to past 30 days) Data are from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (September 2013–December 2014)

Figure 2. Percent of Population at Different Levels of Tobacco Product Uptake Continuum for Each Year of Age, With Smoothed Line From Model*. Sample size (N): 13,651 (12–17 years), 9,112 (18–24 years)

Data are from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (September 2013–December 2014) * Model from PROC LOESS in SAS with local quadratic fitting, scaling fraction of 0.1 and AICC criterion for smoothing. Current Users: Youth ever users who reported using the product in the past 30 days were classified as current users. Young adult ever users were asked “Do you now <use product> every day, some days, not at all; those who did not report use were asked “In the past 30 days, have you <used product> even one or two <times>. Young adults who reported using every day, some days or in the past 30 days were classified as current users. Non-Current Users: Youth and young adult ever users who reported no use of the product in the past 30 days and young adults who did not report some day or everyday use were classified as non-current users.