A new classification system for describing concurrent use of nicotine vaping products alongside cigarettes (so‐called ‘dual use’): findings from the ITC‐4 Country Smoking and Vaping wave 1 Survey

Abstract

Aims To determine whether a simple combination of level of smoking and level of vaping results in a useful typology for characterizing smoking and vaping behaviours. Methods Cross-sectional data from adults (≥ 18 years) in the 2016 wave 1 ITC Four Country Smoking and Vaping Survey in the United States (n = 2291), England (n = 3591), Australia (n = 1376) and Canada (n = 2784) were used. Participants who either smoked, vaped or concurrently used both at least monthly were included and divided into eight groups based on use frequency of each product (daily, non-daily, no current use). This resulted in four concurrent use groups (predominant smokers, dual daily users, predominant vapers and concurrent non-daily users). These groups were compared with each other and with the four exclusive use groups, on socio-demographics, nicotine dependence, beliefs and attitudes about both products, and quit-related measures using data weighted to reference population surveys in each country. Results Of the sample, 10.8% were concurrent users, with daily smokers vaping non-daily (predominant smokers), constituting 51.6% of this group. All eight categories differed from other categories on at least some measures. Concurrent daily nicotine users reported higher levels of indicators of nicotine dependence, and generally more positive attitudes toward both smoking and vaping than concurrent non-daily users. Among daily nicotine users, compared with exclusive daily smokers, reports of interest in quitting were higher in all concurrent use groups. Dual daily users had the most positive attitudes about smoking overall, and saw it as the least denormalized, and at the same time were equally interested in quitting as other concurrent users and were most likely to report intending to continue vaping. Conclusions In Australia, Canada, England and the United States in 2016, daily nicotine users differed considerably from non-daily nicotine users. Among daily nicotine users, dual daily users (those who smoke and vape concurrently) should be treated as a distinct grouping when studying relationships between smoking and vaping. The eight-level typology characterizing concurrent and exclusive use of smoking and vaping should be considered when studying both products.

Reasons for regular vaping and for its discontinuation among smokers and recent ex‐smokers: findings from the 2016 ITC Four Country Smoking and Vaping Survey

“…To fulfil a different research goal, these four groups were defined differently to those in Borland et al . in this Supplement.…”

Concurrent Daily and Non-Daily Use of Heated Tobacco Products with Combustible Cigarettes: Findings from the 2018 ITC Japan Survey

“…Concurrent use is a term that has been commonly used in literature to describe heterogenous group of users of two or more tobacco products. However, concurrent users differ in a wide-ranging set of tobacco behaviors [24], e.g., frequency and amount of each product used. This concept has previously been evaluated for concurrent cigarette-NVP users from four different countries (the United States (US), England, Australia, and Canada) by Borland et al [24].…”

“…However, concurrent users differ in a wide-ranging set of tobacco behaviors [24], e.g., frequency and amount of each product used. This concept has previously been evaluated for concurrent cigarette-NVP users from four different countries (the United States (US), England, Australia, and Canada) by Borland et al [24]. In their study, four subgroups of concurrent cigarette-NVP users were described, differing in nicotine dependence, quit behaviors, and attitudes toward tobacco products [24].…”

“…This concept has previously been evaluated for concurrent cigarette-NVP users from four different countries (the United States (US), England, Australia, and Canada) by Borland et al [24]. In their study, four subgroups of concurrent cigarette-NVP users were described, differing in nicotine dependence, quit behaviors, and attitudes toward tobacco products [24]. Based on frequency of each product use, the study classified concurrent cigarette-NVP users to: (1) Dual daily users (those who use both cigarette and NVP daily), (2) Predominant smokers (those who use cigarette daily and NVP less than daily), (3) Predominant vapers (those who use NVP daily and cigarette less than daily), and (4) Concurrent non-daily users (those who use both cigarette and NVP less than daily) [24].…”

Predicting the future of smoking in a rapidly evolving nicotine market‐place

“…However, that is precisely the challenge that investigators involved with the International Tobacco Control Policy Evaluation (ITC) Project have taken on as reported in this special issue of Addiction . This issue contains 13 papers spanning a wide range of topics from broad descriptions of NVPs and usage patterns, motivations for using vaping products, beliefs and attitudes about nicotine vaping and the impact of various policies on vaping and smoking behaviors, and the projected impact on population health outcomes .…”