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Comparative Study
. 2020 May;29(Suppl 3):s178-s190.
doi: 10.1136/tobaccocontrol-2019-055573.

Initiation of any tobacco and five tobacco products across 3 years among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016)

Cassandra A Stanton  1   2 , Eva Sharma  3 , Elizabeth L Seaman  3 , Karin A Kasza  4 , Kathryn C Edwards  3 , Michael J Halenar  3 , Kristie A Taylor  3 , Hannah Day  5 , Gabriella Anic  5 , Lynn C Hull  5 , Maansi Bansal-Travers  4 , Jean Limpert  5 , Lisa D Gardner  5 , Hoda T Hammad  5 , Nicolette Borek  5 , Heather L Kimmel  6 , Wilson M Compton  6 , Andrew Hyland  4
Affiliations
Comparative Study

Initiation of any tobacco and five tobacco products across 3 years among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016)

Cassandra A Stanton et al. Tob Control. 2020 May.

Abstract

Objective: This study reports weighted cross-sectional prevalence of never use of tobacco, and longitudinal past 12-month (P12M), past 30-day (P30D) and frequent P30D any tobacco or specific tobacco product initiation across three 1-year waves. Longitudinal three-wave pathways are examined to outline pathways of exclusive and polytobacco initiation, as well as pathways of new initiators of electronic nicotine delivery systems (ENDS) or cigarettes.

Design: Data were drawn from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, N = 11 046; young adults, N = 6478; adults 25+, N = 17 188) were included in longitudinal analyses.

Results: Across the three age groups, weighted cross-sectional analyses revealed never any tobacco use decreased each year from 2013 to 2016, reflecting overall increases in tobacco initiation in the population during this time. Compared with cigarettes, cigars, hookah and smokeless tobacco, ENDS had the highest proportion of P12M initiation from Wave 1 to Wave 3 (W3) for each age group. Among youth Wave 2 P30D initiators of exclusive ENDS or cigarettes, the most common W3 outcome was not using any tobacco (ENDS: 59.0% (95% CI 48.4 to 68.8); cigarettes: 40.3% (95% CI 28.7 to 53.1)).

Conclusions: Initiation rates of ENDS among youth and young adults have increased the number of ever tobacco users in the US prevention strategies across the spectrum of tobacco products which can address youth initiation of tobacco products.

Keywords: non-cigarette tobacco products; prevention; surveillance and monitoring.

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Conflict of interest statement

Competing interests: WMC reports long-term stock holdings in General Electric Company, 3M Company, and Pfizer Incorporated, unrelated to this manuscript. No financial disclosures were reported by the other authors of this paper.

Figures

Figure 1:
Figure 1:
Cross-sectional weighted percentages of never tobacco use among youth, young adults and adults 25+ in W1, W2 and W3 of the PATH Study. W1 = Wave 1; W2 = Wave 2; W3 = Wave 3; PATH = Population Assessment of Tobacco and Health W1/W2/W3 never tobacco use unweighted Ns: youth (ages 12–17) = 10 246/8721/8487; young adults (ages 18–24) = 1755/1850/2096; adults 25+ (ages 25 and older) = 2761/2323/2193. X-axis shows three age groups: youth, young adults and adults 25+. Y-axis shows weighted percentages of W1, W2 and W3 never users in these three age groups. Sample analyzed includes all W1, W2 and W3 respondents at each wave. The PATH Study cross-sectional (W1) or single-wave weights (W2 and W3) were used to calculate estimates at each wave. All respondents with data at one wave are included in the sample for that wave’s estimate and do not need to have complete data at all three waves. Never tobacco use is defined as not having used any tobacco, even once or twice in lifetime. a Significant difference at p<0.0167 (Bonferroni corrected for three comparisons) between W1 and W2. b Significant difference at <0.0167 (Bonferroni corrected for three comparisons) between W1 and W3. c Significant difference at <0.0167 (Bonferroni corrected for three comparisons) between W2 and W3. The logit-transformation method was used to calculate the 95% CIs. Analyses were run on the W1, W2 and W3 public use files (https://doi.org/10.3886/ICPSR36498.v8).
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