Correlates of tobacco product reuptake and relapse among youth and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

Abstract

ObjectiveThis study examines sociodemographic and tobacco use correlates of reuptake and relapse to tobacco use across a variety of tobacco products (cigarettes, electronic nicotine delivery systems, cigars, hookah and smokeless tobacco) among the US population.DesignData were drawn from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (ages 12–17) and adults (ages 18+). Reuptake (past 30-day use among previous tobacco users) and relapse (current use among former established users; adults only) were examined among previous users of at least one type of tobacco product at Wave 1 (W1) or Wave 2 (W2) (n=19 120 adults, n=3039 youth). Generalised estimating equations were used to evaluate the association between demographic and tobacco use characteristics at baseline, with reuptake/relapse at follow-up, over two 1-year periods (W1–W2 and W2–Wave 3).ResultsAny tobacco product reuptake occurred in 7.8% of adult previous users and 30.3% of youth previous users. Correlates of any tobacco reuptake included being male, non-Hispanic black and bisexual in adults, but race and sexual orientation were not consistent findings in youth. Among recent former users, relapse rates were greater (32.9%). Shorter time since last use and greater levels of tobacco dependence showed the strongest association with any tobacco relapse.DiscussionContinued clinical and public health efforts to provide adults with tools to cope with tobacco dependence symptoms, especially within the first year or two after quitting, could help prevent relapse.

Correlates of tobacco product cessation among youth and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

“…For example, adults with low income are less likely to quit cigarette smoking when they try and are more likely to relapse after they quit. 39 We also see that a history of tobacco product use predicts transitions both toward and away from using another tobacco product, and additional waves of data will track the stability/transience of tobacco use behaviours over longer periods of time. 1-5 40 suMMArY AnD IMPlICATIOns Demographic correlates of tobacco cessation behaviours underscore tobacco use disparities in the USA, such as socioeconomic disparities in cigarette use, which calls for renewed efforts to reduce tobacco use disparities.…”

“…36 As with survey designs in general, it is also possible that some participants failed to recall having made a quit attempt. 37 Despite these limitations, and taken together with correlates of tobacco product initiation 38 and tobacco product relapse behaviours, 39 findings underscore tobacco use disparities in the USA. For example, adults with low income are less likely to quit cigarette smoking when they try and are more likely to relapse after they quit.…”

Longitudinal pathways of exclusive and polytobacco hookah use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

“…Future studies can also examine correlates that predict these unique patterns among exclusive and non-exclusive hookah users. Kasza et al 44 45 and Edwards et al 46 examine demographic correlates of initiation, cessation and relapse of hookah use to further explore predictors of these outcomes.…”

Overview of tobacco use transitions for population health

“…Figure 1 shows that the broad transitions of initiation, cessation and relapse can occur in steps (denoted by showing two arrows between user states); for example, cigarette smoking cessation is composed of moving from being a current smoker to making a quit attempt to succeeding in a quit attempt. Three papers in this issue describe correlates of the broad transitions of initiation,22 cessation23 and relapse24 for each type of tobacco product, along with correlates of steps within each of these transitions over a 1-year time frame using data from W1 to W2 and from W2 to W3 of the PATH Study. Table 2 lists the individual-level initial correlates considered in this issue for each of the broad transitions and steps within them, though other factors at the environment level or product level, for example, may also relate to transition behaviours or interact with individual-level correlates to affect transition behaviours.…”

“…Specifically, we outline a high-level conceptual overview to guide thinking about three broad transition behaviours: (1) initiation of tobacco use among non-users; (2) cessation of use among current users; and (3) relapse back to tobacco use among former users. These transition behaviours can apply to several different types of tobacco products4–9 and may be influenced by a set of demographic and tobacco use correlates 22–24. The papers that follow in this journal issue use this overview for different tobacco products among youth 12–17 years of age, young adults 18–24 years of age and adults 25 years of age and older.…”