Adolescent Cigarette Smokers' and Non-Cigarette Smokers' Use of Alternative Tobacco Products

Abstract

More information on adolescent use of alternative tobacco products is needed. Current cigarette use declined 3.4% annually over 2004-2009 for the NYTS 14- to 17-year-old population, but this cohort's use of alternative tobacco products was unchanged. The number of adolescents aged 14-17 who did not smoke cigarettes but used alternative tobacco products increased 5.9% per year over the same period. Current surveillance measures need to be expanded in order to gain a more comprehensive understanding of adolescent alternative tobacco use.

Increasing hookah use among adolescent females in the US: analyses from the 2011-2014 National Youth Tobacco Survey (NYTS)

“…Our findings show that the odds of using e-cigarettes in the past 30 days are more than four times greater for hookah users, while the odds of using cigarettes in the past 30 days are more than five times greater among hookah users. This is not surprising, as previous analysis of data from the NYTS found that use of one alternative tobacco product is a risk factor for using another, among cigarettes smokers and non-cigarette smokers 27 . Odds ratios for use of various alternative tobacco products as a risk factor for using another type of alternative tobacco product varied from 1.52 (95% CI 1.12, 2.07) to 60.97 (95% CI 31.38, 118.45) among respondents 27 .…”

“…This is not surprising, as previous analysis of data from the NYTS found that use of one alternative tobacco product is a risk factor for using another, among cigarettes smokers and non-cigarette smokers 27 . Odds ratios for use of various alternative tobacco products as a risk factor for using another type of alternative tobacco product varied from 1.52 (95% CI 1.12, 2.07) to 60.97 (95% CI 31.38, 118.45) among respondents 27 . Additionally, studies associate e-cigarette use with increased intention to smoke cigarettes, openness to trying cigarettes, and the actual initiation of cigarette smoking [31][32][33] .…”

“…The increase in adolescent female hookah use may serve as a harbinger of resurgence in increased female use of other tobacco products. Research shows that use of one tobacco product correlates with use of other tobacco products 27 , and the history of adolescent female cigarette use shows that female rates have spiked in the past 26 . This finding has implications for health care providers, legislators, and those pushing back against the specific targeting of females by purveyors of tobacco.…”

“…Companies produced "light" or "slim" products to target the female population, and advertising correlates with increased use 30 . It is not yet clear why female use of hookahs is increasing.…”

Hookah Use Among US High School Seniors

“…5,6 A recent report from the Centers for Disease Control and Prevention warns that the drop in cigarette consumption is being "offset by increases in other forms of tobacco." 7 Although alternative tobacco use may have originated among immigrants from South Asia and the Middle East, use of hookah has clearly moved into the mainstream US population.…”