Multiple tobacco product use among adolescents

Although cigarette use is declining among U.S. teens, smokeless tobacco and cigars have shown no decline in over 5 years according to YRBS trends. Alternative products pose negative health risks, and there is a risk for multiple tobacco product use. This study examined multiple tobacco product use among teens. Data were collected from a convenience sample of 4,178 9th-12th grade students enrolled in five high schools using the 2011 YRBS. Rates of current use (defined as any use in the past 30 days) were as follows: cigarettes (16.2%), cigar (13.9%), and smokeless tobacco (5.1%). Males (18.8%) reported higher cigarette use than females (13.6%; X2(1) = 20.2, p<.000), nearly double the cigar use (18.0% vs 9.9%; X2(1)=56.2, p<.000), and higher smokeless tobacco use (9.3% vs 1.0%; X2(1) = 147.0, p<.000). Current use of at least two or more products was reported by 10.1% of respondents. Males also reported current use of two or more products at twice the rate of females (14.1% vs 6.3%; X2(1) = 79.8, p<.000). National adolescent cigar use rates are unchanged since 2005, smokeless tobacco products are unchanged since 2003, whereas cigarette use has decreased among teens since 1997. New policies are aimed toward cigarettes, leaving cigars and smokeless tobacco unchanged. Given the likely exponential harm in multiple tobacco product use, efforts to curb all tobacco use needs to be addressed.