title: Types of Dual and Poly-Tobacco Users in the US Military.
abstract: The present investigation was designed to determine the prevalence and types of dual and poly-use of tobacco products in the US Air Force, as well as characteristics and factors associated with these types. We conducted a cross-sectional assessment of tobacco-product use among 13,873 Air Force trainees from 2013 to 2014. The assessment included prevalence of the use of 10 different tobacco products and demographic and environmental factors, such as risk perceptions of tobacco use, peer use, and tobacco-company influences. Latent class analysis was carried out to determine types of poly-tobacco users. Tobacco-product use was reported by 27.1% of participants, and of those, over half reported using more than 1 tobacco product. Latent class analysis indicated 5 classes of poly-tobacco use. Factors associated with poly-tobacco (vs. mono-tobacco) use included lower confidence to remain tobacco-free, low harm perceptions, and receiving tobacco products free at bars or social events. Rates of dual and poly-tobacco use are high among trainees, and while these groups are similar to mono users in some ways, there are a number of differences that need to be considered when developing targeted interventions to address use of multiple tobacco products.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Little
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bursac
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Derefinko
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.forename: Gerald W
authors.initials: GW
authors.lastname: Talcott
authors.forename: Ann
authors.initials: A
authors.lastname: Hryshko-Mullen
authors.forename: Robert C
authors.initials: RC
authors.lastname: Klesges
mesh_terms: D017677:Age Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D010379:Peer Group; D015995:Prevalence; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D012931:Social Environment; D011795:Surveys and Questionnaires; D019460:Tobacco Industry / Q000379:methods* / Q000706:statistics & numerical data; D062789:Tobacco Products / Q000145:classification / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D000072137:Vaping / Q000453:epidemiology; D055815:Young Adult
keywords: alternative tobacco products; dual tobacco use; military personnel; poly-tobacco use; risk factors; smokeless tobacco; smoking; tobacco