title: Exploring Exclusive and Poly-tobacco Use among Adult Cigarette Smokers in Minnesota.
abstract: OBJECTIVE
  In recent decades, the United States has seen dramatic reductions in cigarette smoking. In contrast, other tobacco products (OTPs) have increased in popularity, particularly electronic cigarettes. The availability of new OTPs also has led to the use of multiple tobacco products that includes combustible cigarettes (poly-use). This study examines patterns of exclusive cigarette and polyuse among adult smokers in Minnesota.
  
  
  METHODS
  Data from 5 rounds of the Minnesota Adult Tobacco Survey (MATS) series 1999-2014 were analyzed. Weighted estimates of the prevalence of exclusive and poly-tobacco use were calculated. The use of multiple tobacco products was contrasted with past 30-day exclusive cigarette smoking. Poly-use was measured as the current use of combustible cigarettes plus past 30-day use of another tobacco product.
  
  
  RESULTS
  The percentage of Minnesota adults who used at least 2 tobacco products increased from 3.2 in 1999 to 5.8 in 2014. The most common combination of products in 2014 was combustible cigarettes and electronic nicotine delivery systems (ENDS), a combination that increased significantly between 2010 and 2014. Compared to exclusive cigarette smoking, poly-users were more likely to be younger and male.
  
  
  CONCLUSIONS
  In this state-based survey, the number of people using multiple tobacco products remains modest but nearly doubled from 1999 to 2014. Further surveillance should discern motivations and patterns of use among poly-users.
authors.affiliation: ClearWay Minnesota, Research Program Manager, Minneapolis, MN.
authors.forename: Erin
authors.initials: E
authors.lastname: O'Gara
authors.affiliation: Westat, Research Associate, Rockville, MD.
authors.forename: Eva
authors.initials: E
authors.lastname: Sharma
authors.affiliation: ClearWay Minnesota, Director of Research Programs, Minneapolis, MN.
authors.forename: Raymond G
authors.initials: RG
authors.lastname: Boyle
authors.affiliation: Westat, Senior Study Director, Rockville, MD;, Email: eogara@clearwaymn.org.
authors.forename: Kristie A
authors.initials: KA
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D000074285:Smokers; D012907:Smoking / Q000453:epidemiology; D064424:Tobacco Use; D014481:United States; D055815:Young Adult