142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

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

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 1:10 PM - 1:30 PM

Louisa Holmes, PhD , Center for Tobacco Control Research & Education, University of California San Francisco, San Francisco, CA
Pamela Ling, MD, MPH , Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA

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.


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). 


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.


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.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain differences in use of alternative tobacco products by geography and race/ethnicity. Describe correlates of poly-tobacco use among young adults.

Keyword(s): Tobacco Use, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been an investigator on four population-based surveys examining topics related to tobacco use and other risk behaviors, health and chronic disease and have published several studies employing these data to investigate health and geographic disparities in tobacco-related disease, among other topics. I earned my PhD in Geography, focusing on place-based disparities in health outcomes, and my Masters in Public (Health) Policy.
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.