Alternative tobacco product use among young adult bar patrons: A six city study

BACKGROUND:

Smoking rates in the USA have declined in recent years, but this decline has not been geographically or demographically uniform, and the use of the alternative tobacco products has risen.  We describe cigarette and alternative tobacco product (cigar, hookah, smokeless tobacco, snus, and electronic cigarettes) use among young adult bar patrons in six U.S. cities.

METHODS:

We employed time location sampling to randomly survey young adults, ages 18-26, (n=6,811) from six cities – Albuquerque, Nashville, New York City, San Diego, San Francisco and Tucson  – to investigate prevalence rates and predictors of alternative tobacco product use and poly-tobacco use (use of more than 1 tobacco product for at least 3 of the past 30 days). 

RESULTS:

The use of alternative tobacco products varied by city and race/ethnicity. The most commonly used products were cigarettes, which ranged from 30.2% (Tucson) to 50.2% (San Francisco), hookah ranged from 14% (Nashville) to 37% (New York), and e-cigarette use which ranged from 10% (Nashville) to 24% (Albuquerque).  In all cities, men were significantly more likely to use a combination of tobacco products (p<.05) than women, while Latinos in New York (OR: 1.75, CI: [1.3, 2.5]) and Non-Hispanic blacks in San Diego (OR: 2.42, CI: [1.1, 5.6]) were more likely than Non-Hispanic whites to be poly-tobacco users.

CONCLUSION:

Bar-going young adults are at risk of alternative tobacco product use and poly-tobacco use, but the risk varies geographically and by race/ethnicity.  High rates of hookah and e-cigarette use among non-white young adults warrant further investigation.