Online Program

Three year trends in the use of emerging tobacco products

Tuesday, November 5, 2013

Robert C. McMillen, PhD, Social Science Research Center, Mississippi State University, Starkville, MS
Mark A. Gottlieb, JD, at Northeastern Univ. School of Law, Public Health Advocacy Institute, Boston, MA
Regina M. Shaefer, MPH, Julius B Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, IL
Jonatha Winickoff, MD, MPH, MGH Center for Child and Adolescent Health Policy, Boston, MA
Jonathan Klein, MD, MPH, American Academy of Pediatrics, Elk Grove Village, IL
Background: Snus and electronic cigarettes have recently been introduced to the US market. These products and hookah waterpipes have been heavily promoted; however, to date, FDA only has regulated snus. We assess three year trends in use of these products among US adults, and current predictors of electronic cigarette use.

Methods: In 2010-2012, we applied a mixed-mode survey to obtain annual, representative samples of US adults.

Results: In weighted analysis, lifetime prevalence of snus use (5.1% to 6.5%) and water pipe (8.8% to 9.9%) did not significantly change from 2011-12. Lifetime prevalence of electronic cigarettes increased from 1.8% to 10.8%, p <.001. In 2012, daily smokers (44.8%) and nondaily smokers (24.5%) were the most likely to have tried electronic cigarettes, compared to former smokers (7.5%) and never smokers (1.7%). Younger (12.8%) and middle aged adults (13.4%) compared to older adults (2.4%) and those without a high school degree (10.9% vs 7.4%) were more likely to have tried electronic cigarettes (p<.05 for all comparisons). In multivariable analysis, current daily (OR=53.3 , 95% CI = 34.0–83.6), nondaily (20.2, 11.0–37.2), and former smoking status (6.6, 4.1–10.5) remained significant, as did young (7.2, 3.5–15.0) and middle aged adults (6.7, 3.9-11.3).

Conclusion: Use of emerging tobacco products raises concerns about nonsmokers being at risk for nicotine dependence, current smokers maintaining their dependence, and the impact of poly-tobacco use. Greater awareness of emerging tobacco product prevalence and the high risk demographic user groups will inform efforts to determine appropriate public health policy and regulatory action.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the three year trend in use of emerging tobacco products.

Keyword(s): Tobacco Policy, Tobacco Control

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I direct the National Social Climate Survey of Tobacco Control through a cooperative project with the Social Science Research Center and the American Academy of Pediatrics’ Julius B. Richmond Center. I also serves as Principal Investigator for the Surveillance and Evaluation Services grant for the Mississippi State Department of Health’s Office of Tobacco Control.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.