title: Use of multiple tobacco products in a national sample of persons enrolled in addiction treatment.
abstract: To explore use of tobacco products in relationship to marketing exposure among persons in addiction treatment.
  
  
  
  A random sample of treatment programs was drawn from the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). Participants in each program completed surveys concerning use of tobacco products (N=1113). Exposure to tobacco marketing and counter-marketing, advertising receptivity, and perceived health risks of smoking were tested for their association with use of multiple tobacco products.
  
  
  
  Prevalence of combustible cigarette use was 77.9%. Weekly or greater use of other products was: e-cigarettes (17.7%), little filtered cigars (8.6%), smokeless tobacco (5.2%), and standard cigars (4.6%) with 24.4% using multiple tobacco products. Compared to single product users, multiple product users smoked more cigarettes per day (OR=1.03, 95% CI 1.01-1.05, p<0.001), were more likely to have tried to quit (OR=1.41, 95% CI 1.02-1.96, p=0.041), reported greater daily exposure to advertising for products other than combustible cigarettes (OR=1.93, CI 1.35-2.75, p<0.001), and greater daily exposure to tobacco counter-marketing (OR=1.70, 95% CI: 1.09-2.63, p=0.019).
  
  
  
  Heavier smokers and those trying to quit may be more likely to use e-cigarettes, little filtered cigars, or smokeless tobacco and have greater susceptibility to their advertising. This highlights the importance of regulating advertising related to smoking cessation as their effectiveness for this purpose has not been demonstrated.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States. Electronic address: joseph.guydish@ucsf.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: Guydish
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tajima
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Pramod
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
authors.forename: Thao
authors.initials: T
authors.lastname: Le
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
authors.forename: Noah R
authors.initials: NR
authors.lastname: Gubner
authors.affiliation: Department of Public Health and Preventive Medicine, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Campbell
authors.affiliation: Center for Research on Behavioral Health and Human Service Delivery, Owens Institute for Behavioral Research, 106 Barrow Hall, University of Georgia, Athens, GA 30602, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Roman
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D040541:Marketing / Q000379:methods; D008875:Middle Aged; D054577:National Institute on Drug Abuse (U.S.); D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D016320:Substance Abuse Treatment Centers / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*; D014481:United States
keywords: Drug treatment; Nicotine; Policy; Tobacco