Patterns of Single and Multiple Tobacco Product Use Among US Women of Reproductive Age

Abstract

IntroductionUnderstanding patterns of single and multiple tobacco product use among reproductive-aged women is critical given the potential for adverse health effects on mother and infant should a woman become pregnant.MethodsPatterns of tobacco use over a 2-year period were examined among all women (18–44 years) who completed wave 1 (W1) and wave 2 (W2) of the US Population Assessment of Tobacco and Health (PATH, 2013–2014, 2014–2015) Study. We examined the most common patterns of single and multiple tobacco product use in W1, and longitudinal trajectories of women engaged in each of these patterns of use from W1 to W2, among women not pregnant in either wave (n = 7480), not pregnant in W1 and pregnant in W2 (n = 332), and pregnant in W1 and not pregnant in W2 (n = 325).ResultsThe most prevalent patterns of tobacco use in W1 among all three subgroups were using cigarettes alone followed by using cigarettes plus e-cigarettes. In all three subgroups, women using multiple products in W1 were more likely to adopt new use patterns in W2 relative to single-product users, with the new patterns generally involving dropping rather than adding products. The majority of multiple product use included cigarettes, and transitions to single product use typically involved dropping the noncigarette product. The most common trajectory among tobacco users transitioning to or from pregnancy was to use cigarettes alone in W2.DiscussionThis study contributes new knowledge characterizing tobacco use patterns across time and reproductive events among reproductive-aged women.

Patterns and Correlates of Multiple Tobacco Product Use in the United States

“… 24 This study also identified that for all women, regardless of pregnancy status, cigarettes were the most common product used and that the majority of polytobacco use included cigarettes plus at least one additional product, with women generally discarding the alternative tobacco product over time and continuing to smoke conventional tobacco cigarettes. 24 …”

“… 23 Kurti et al analyzed PATH Study data (Waves 1 and 2) to examine how patterns of tobacco product use change among reproductive-aged women over time and when transitioning either into or out of pregnancy. 24 Results indicated that, regardless of pregnancy status, patterns of use involving more products were less stable over time, with dual and poly users generally dropping rather than adding products across waves. 24 This study also identified that for all women, regardless of pregnancy status, cigarettes were the most common product used and that the majority of polytobacco use included cigarettes plus at least one additional product, with women generally discarding the alternative tobacco product over time and continuing to smoke conventional tobacco cigarettes.…”

“… 18 , 20–23 , 26 Four other papers used different time-based ranges, one looking at past-week cigarillo and cigarette use, 16 one looking at past 6-month use of cigarettes, e-cigarettes, and hookah, 19 and the other two papers defined polytobacco use as currently using more than one product every day or some days. 24 , 25 The remaining two papers do not fit into these categories as one does not define use because they studied the products themselves 27 and the other used ecological momentary assessment methods to assess frequency (days smoked) and amount (products smoked per day). 17 As definitions and analytic approaches evolve, results across studies should reveal whether definitions such as concurrent past 30-day use are the most appropriate measures to fully understand the impact of polytobacco use on nicotine dependence, smoking cessation, individual-level health effects, and net population health impact.…”

Changes in Cigarette Consumption With Reduced Nicotine Content Cigarettes Among Smokers With Psychiatric Conditions or Socioeconomic Disadvantage

“… 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Overrepresentation of smoking among populations with psychiatric conditions and socioeconomic disadvantage requires examination of how these high-risk populations respond to reduced nicotine–content cigarettes. 1 , 2 , 3 , 4 , 5 , 6 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”

The use of electronic nicotine delivery systems during pregnancy and the reproductive outcomes: A systematic review of the literature

“…Subsequent waves of the PATH study provided estimates for the odds of quitting ENDS or cigarettes related to pregnancy that were higher for ENDS and hookahs than cigarette smoking 38 . In addition, the study has depicted the trajectories of use among ENDS dual users before pregnancy (Wave 1) and once they become pregnant (Wave 2); more than half (52.5%) stopped using ENDS once they became pregnant but continued to smoke cigarettes 37 .…”