Patterns and correlates of polytobacco use in the United States over a decade: NSDUH 2002-2011.
BACKGROUND
Few studies have examined the patterns and correlates of polytobacco use among a large, nationally representative population over an extended period of time.


METHODS
This study examined 10years of data from the National Survey on Drug Use and Health (NSDUH) to establish time trends and correlates for exclusive and mixed use of cigarettes, smokeless tobacco (SLT), cigars, and pipes.


RESULTS
Results show that rates of polytobacco use were essentially unchanged from 2002 to 2011 (8.7% to 7.4%), though some product combinations, including cigarettes and SLT, cigars and SLT, and use of more than two products have increased. In tobacco users under age 26, the proportion of polytobacco use increased, even as overall tobacco use declined. The factors associated with polytobacco use among tobacco users included sex, income, education, risk taking/seeking behaviors, and outward indicators of 'risk-liability'.


CONCLUSIONS
Findings provide a snapshot of trends of single and polytobacco product use as well as trends in combinations of product use. Longitudinal studies are needed to examine the sequence of individual patterns of tobacco product use and to identify whether polytobacco use results in greater nicotine dependence, increased exposure to harmful and potentially harmful constituents and/or greater risk of tobacco related disease.
Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA. Electronic address: brian.fix@roswellpark.org.
Brian V
BV
Fix
Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA.
Richard J
RJ
O'Connor
Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA.
Lisa
L
Vogl
Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA.
Danielle
D
Smith
Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA.
Maansi
M
Bansal-Travers
National Institutes of Health, National Institute on Drug Abuse, 6001 Executive Boulevard, Bethesda, MD 20892, USA.
Kevin P
KP
Conway
United States Food and Drug Administration, Center for Tobacco Products, 9200 Corporate Boulevard, Rockville, MD 20850, USA.
Bridget
B
Ambrose
United States Food and Drug Administration, Center for Tobacco Products, 9200 Corporate Boulevard, Rockville, MD 20850, USA.
Ling
L
Yang
Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA.
Andrew
A
Hyland
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012959:Socioeconomic Factors; D062789:Tobacco Products / Q000145:classification / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology* / Q000639:trends*; D014029:Tobacco Use Disorder / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Cigarettes; Cigars; Polytobacco use; Smokeless tobacco; Tobacco; Tobacco use trends