Smoking Status and Use of Other Forms of Tobacco Products: Results of a National Survey

Background

While cigarette smoking has declined among U.S. adults, use of other forms of tobacco products (e.g., hookah, e-cigarettes, pipe tobacco, roll your own (RYO) tobacco and chewing tobacco) has increased in recent years. Still, there is only limited research available that examines how smoking status is associated with use of other forms of tobacco products. Hence, we investigate cigarette smoking status and demographics as predictors of use of other forms of tobacco products.   

Methods

Data from the U.S. Health Information National Trends Survey (HINTS-FDA-2015; N=2584) were used. Other forms of tobacco products such as hookah, e-cigarettes, pipe tobacco, roll your own (RYO) tobacco and chewing tobacco, and smoking status (current, former and never) were measured. Demographic information (gender, race/ethnicity, age group, household income, education, and smoking status) was included. Multiple logistic regression analyses were used to examine how smoking status predicted each form of other tobacco products after controlling for demographics.

Results

More male than female adults were likely to use hookah tobacco, pipes, RYO tobacco and chewing tobacco. Compared with white adults, both African American and Hispanic/Latino adults were more likely to use pipes and chewing tobacco. Young and middle aged adults were more likely to use hookah, e-cigarettes, RYO tobacco and chewing tobacco than older adults. On the other hand, older adults were more likely to use pipes than older adults. Household income positively predicted only hookah. Interestingly, compared with nonsmokers, both current smokers and former smokers were significantly more likely to use each form of the five other tobacco products when controlling for the demographic variables.

Conclusion

Tobacco use is one of the most important causes of many chronic diseases. All forms of tobacco products should be discouraged to prevent negative health consequences. Our study showed those who have ever smoked cigarettes were likely to use other forms of tobacco. Therefore, smoking cessation programs should address other forms of tobacco products, paying attention to the variation in demographic characteristics.