title: Which nicotine products are gateways to regular use? First-tried tobacco and current use in college students.
abstract: BACKGROUND
  The potential for emerging tobacco products (ETPs) to be gateway products for further tobacco use among youth is of significant concern.
  
  
  OBJECTIVE
  To examine use of various nicotine-containing products on a tobacco-free college campus and whether the first product tried predicts subsequent tobacco use.
  
  
  METHODS
  Undergraduate students (N=1,304) at a large university completed an online survey of past/current use of cigarettes; smokeless tobacco (SLT); hookah; ETPs (dissolvables, snus, and electronic cigarettes); and nicotine replacement therapy (NRT). Data were collected from September 2012 to May 2013 and analyses were conducted from June to September 2013. Students were classified as single, dual, or poly tobacco users.
  
  
  RESULTS
  The sample consisted of 79.5% non-users, 13.8% single, 4.4% dual, and 1.5% poly users. Overall, 49.4% of participants reported trying a tobacco product. Hookah was the most tried product (38%), but cigarettes were most often the first product ever tried (51%). First product tried did not predict current tobacco use and non-use, but individuals who first tried SLT or cigarettes (rather than hookah or ETPs) were more likely to be poly tobacco users. Current tobacco users who first tried ETPs or hookah were largely non-daily users of hookah; current tobacco users who first tried cigarettes or SLT were largely non-daily or daily users of cigarettes/SLT.
  
  
  CONCLUSIONS
  Hookah and ETPs are increasingly becoming the first tobacco product ever tried by youth; however, uptake of ETPs is poor, unlike cigarettes and SLT, and does not appear to lead to significant daily/non-daily use of cigarettes and SLT.
authors.affiliation: Oklahoma State University, Department of Psychology, Stillwater; Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma. Electronic address: ellen.meier@okstate.edu.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Meier
authors.affiliation: Oklahoma State University, Department of Psychology, Stillwater; Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma.
authors.forename: Alayna P
authors.initials: AP
authors.lastname: Tackett
authors.affiliation: Oklahoma State University, Department of Psychology, Stillwater.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Miller
authors.affiliation: Oklahoma State University, Department of Psychology, Stillwater; Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma.
authors.forename: DeMond M
authors.initials: DM
authors.lastname: Grant
authors.affiliation: University of Oklahoma Health Sciences Center, Section of General & Community Pediatrics; Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma.
authors.forename: Theodore L
authors.initials: TL
authors.lastname: Wagener
mesh_terms: D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D013334:Students / Q000706:statistics & numerical data*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014495:Universities; D055815:Young Adult