From snus to hookah: Other tobacco product use in the next generation

Background: Other tobacco products (OTP) are considered any tobacco product other than cigarettes; commonly cigars, cigarillos, little cigars, smokeless tobacco, bidis, kreteks or clove cigarettes, snus, and water-pipe tobacco or hookahs. Purpose: To establish the prevalence of OTP use among high school students in a diverse, urban county. We will also determine what type of tobacco product students used first to ascertain which products may be considered “gateway” products. Significance: There have been many documented health consequences associated with tobacco use, yet most legislation and research has focused solely on cigarettes. A significant investment in tobacco control funding was made in Cuyahoga County from 2000-2008; during which time the Clean Indoor Air Act was implemented throughout Ohio. While surveillance data has shown significant decreases in lifetime (44.1% in 2004 to 39.4% in 2009) and current (16.2% to 12.5%) cigarette smoking among high school students, community partners have described increases in the use of OTP. This study hopes to validate or refute these observations by examining OTP use overall and within age, race, and geographic locale subgroups. Methodology: Data will be drawn from the 2011 high school Cuyahoga County Youth Risk Behavior Surveillance System. This survey uses a two-stage cluster sample design; items assessing OTP use will be included. Results: Research will take place in spring, 2011. Conclusions: Because relatively little research has been conducted in this area, this study will add to the overall body of knowledge and inform policy-makers about the necessary inclusion of OTP in tobacco control policy.