Global Patterns and Prevalence of Dual and Poly-Tobacco Use: A Systematic Review

Abstract

Introduction Improving understanding of the epidemiology of dual and poly-tobacco product use is essential for tobacco control policy and practice. The present study aimed to systematically review existing epidemiologic evidence on current dual and poly-tobacco use among adults globally. Methods We systematically searched online databases for studies published up to 30 June 2020. We included quantitative studies with measures of nationally representative prevalence of current dual or poly-tobacco use among adults. Prevalence estimates for each country were extracted manually and stratified by WHO regions and World Bank income classifications. Results Twenty studies with nationally representative prevalence data on current dual or poly-tobacco use in the adult population across 48 countries were included. Definitions of dual and poly-tobacco use varied widely. Prevalence of dual and poly-tobacco use was higher in low- and lower-middle-income countries compared to other higher-income countries. Current dual use of smoked and smokeless tobacco products among males ranged from 0.2% in Ukraine (2010) and Mexico (2009) to 17.9% in Nepal (2011). Poly-tobacco use among males ranged from 0.8% in Mexico (2009) and 0.9% in Argentina (2010) to 11.4% in the UK and 11.9% in Denmark in 2012. Dual tobacco use was generally higher in South-East Asia; poly-tobacco use was prevalent in Europe as well as in South-East Asia. Conclusions This is the first systematic review of the prevalence estimates of dual and poly-tobacco use among adults globally. The results of the current study could significantly help health policy makers to implement effective tobacco control policies.

Dual and poly-use of novel and conventional nicotine and tobacco product use in Europe: Challenges for population health, regulatory policies, and the ways ahead

“…Data source: (A) WHO report on the global tobacco epidemic, 2013 ( 5 ). (B) Chen et al ( 7 ). (C) The Tobacco Control Scale 2019 in Europe ( 4 ).…”

“…While the consumption of conventional products such as cigarettes is slowly decreasing, novel nicotine and tobacco products such as e-cigarettes (vaping products) and heated tobacco products (HTPs) are gaining popularity in the European region since 2017, especially among the younger populations ( 3 ) and in the countries where the prevalence of conventional tobacco products is high ( 6 ). The proliferation of novel or alternative products in the market presents an opportunity for conventional smokers to use these products in combination with conventional ones, leading to dual or poly-product use ( 7 ). The 2020 Eurobarometer survey reports a great proportion of current “dual users” of e-cigarette users (59%) and heated tobacco product users (79%), using these products in addition to their current use of conventional products ( 6 ).…”

Trends in Exclusive, Dual and Polytobacco Use among U.S. Adults, 2014–2019: Results from Two Nationally Representative Surveys

“…Research on patterns of multiple tobacco product use in U.S. adults has increased over the past decade [ 4 , 5 ]. In a systematic review of dual use and polyuse, eleven studies have presented prevalence estimates of dual use, and six studies have presented estimates of polyuse from 1992 to 2018 using data from nationally representative studies [ 5 ]. This review found that dual use and polyuse are becoming more common throughout the world, and that definitions of dual use and polyuse use have varied over time.…”

“…This review found that dual use and polyuse are becoming more common throughout the world, and that definitions of dual use and polyuse use have varied over time. Dual/polyuse is also higher among younger adults compared to older adults in the United States [ 5 , 6 ]. In addition, results from a recent study analyzing three nationally representative surveys for the years 2014–2016 reported that the most common adult dual use and polyuse groups in the United States were cigarettes and electronic nicotine delivery systems (ENDS) dual use (1.3–1.8%), and cigarettes, ENDS, and other combustibles (OC, i.e., cigars/cigarillos/little filtered cigars and traditional pipe/hookah) polyuse (0.2–0.7%) [ 4 ].…”

Prevalence of tobacco dependence among rural population of Mysuru District

“…But for dual use, there are only few documents supporting additional risks, prolonged to nicotine and slow reductions. 4 Factors that make people to get addicted with tobacco include, mental illness (mental stress, depression, post-traumatic stress, schizophrenia, stress disorder etc. ), sadness of grief, impatience, frustrations, boredom, restlessness, anger and also just like that for craze and relaxing purposes.…”