Online Program

329833
From Yummy Gummy to Arctic Ice: Adolescents' Use of Flavored Tobacco Products


Wednesday, November 4, 2015

Lucy Popova, PhD, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
Bonnie Halpern-Felsher, PhD, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA
Kimberly Walsh, MA, Department of Communication, University of California Santa Barbara, Santa Barbara, 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
Background: Smoking rates are declining among U.S. adolescents, but use of other tobacco products is steady or rising. We examined awareness and use of various tobacco products (e-cigarettes, cigars, little cigars, cigarillos, moist snuff, and snus) by demographics, and rates of flavored tobacco product use.

Methods: A nationally representative probability-based cross-sectional survey of 1336 adolescents 13-17 years old conducted in 2014.

Results: Overall, 23.3% of participants tried at least one tobacco product (17.8% conventional cigarettes, 9.1% e-cigarettes, 7.8% cigars, 6.6% little cigars, 6.7% cigarillos, 4.3% moist snuff, and 2.1% snus) and 12% tried multiple tobacco products. White adolescents were more aware of e-cigarettes, smokeless tobacco and cigars, but Black adolescents were more likely to be aware of and use little cigars and cigarillos. Among those who tried any tobacco product, 35.6% reported their first tobacco product was flavored, with significant variation by product (64.8% of e-cigarette users started with a flavored product, 56.7% snus, 47.5% moist snuff, 45.4% cigarillos, and 35.5% little cigars).  Only 24.7% of conventional cigarette smokers started with a flavored cigarette; for 80% of them it was a menthol cigarette. Among those who used tobacco products 6 times or more, 39% (cigarillos) to 56% (e-cigarettes) reported using flavored products often or always.

Conclusions: Many U.S. adolescents begin tobacco experimentation with flavored products and many use multiple tobacco products.  Surveillance and clinical treatment of adolescent tobacco use should address multiple tobacco products.  Policies limiting availability of flavored cigarettes should be extended to include menthol and other tobacco products.

Learning Areas:

Public health or related public policy
Public health or related research

Learning Objectives:
Compare the rates of awareness and use of various tobacco products among U.S. adolescents Demonstrate how the rates of awareness and use of various tobacco products differ among demographic groups Evaluate adolescents’ first experiences with tobacco products in terms of product flavors.

Keyword(s): Tobacco Use, Tobacco Control

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a postdoctoral fellow at the UCSF Center for Tobacco Control Research and Education, and my research interests lie in alternative tobacco use, its relationship to tobacco cessation, and marketing of alternative tobacco products.
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.