title: Polytobacco Use Among College Students.
abstract: BACKGROUND
  Use of more than one tobacco product among college students is increasing in popularity, leading to nicotine addiction and additional health risks. The study (1) examined polytobacco use patterns among college students who had ever used tobacco; and (2) assessed the sociodemographic and personal factors associated with current polytobacco use, compared to current single product use and former tobacco use among college students.
  
  
  METHODS
  Of 10,000 randomly selected college students from a large public university in the Southeast, a sample of 1593 students age 18 or older completed an online survey assessing tobacco use and attitudes. Ever tobacco users were included in this study (n = 662, or 41.6% of survey completers).
  
  
  RESULTS
  About 15% of ever users reported current polytobacco use, and more than 70% of polytobacco users smoked cigars, little cigars, or clove cigarettes in combination with one or more products. Cigarettes were the most commonly-used product among single users, followed by hookah. Males, underclassmen, and students with greater acceptance of cigarette use were more likely to be polytobacco users. Race/ethnicity was marginally related to polyuse status, with white/non-Hispanics 28% less likely to be polytobacco users versus single product users.
  
  
  CONCLUSIONS
  Polytobacco users were more likely than single users to consume emerging tobacco products, (ie, hookah and electronic cigarettes). Males, underclassmen, and racial/ethnic minorities were more at risk for polytobacco use. As young people are particularly prone to nicotine addiction, there is a need to further investigate polytobacco use among college students.
authors.affiliation: College of Nursing, University of Kentucky, Lexington, KY; karen.butler@uky.edu.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Butler
authors.affiliation: Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY;
authors.forename: Melinda J
authors.initials: MJ
authors.lastname: Ickes
authors.affiliation: College of Nursing, University of Kentucky, Lexington, KY;
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Rayens
authors.affiliation: College of Nursing, University of Kentucky, Lexington, KY;
authors.forename: Amanda T
authors.initials: AT
authors.lastname: Wiggins
authors.affiliation: Colleges of Nursing and Public Health, University of Kentucky, Lexington, KY.
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Hahn
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000639:trends; D013334:Students; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014495:Universities / Q000639:trends; D055815:Young Adult