The Next Generation of Tobacco Users

Young adults shown to be using new and alternative forms of tobacco

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Tobacco use among young adults is on the rise, with many of them using more than one type of tobacco product daily.

According to a new study performed during 2011-2012, young American adults have not only been smoking cigarettes and dipping, but have moved towards new and different types of tobacco products as well.

"Seek professional help if you’re struggling with tobacco addiction."

This research was conducted by Amanda Richardson, PhD, MS, of the Johns Hopkins Bloomberg School of Public Health, and colleagues.

According to Dr. Richardson and her team, “Tobacco is the number one cause of preventable death in America and results in 5.2 million years of potential life lost each year."

Since the 1998 Master Settlement Agreement placed restrictions on tobacco marketing to youth, young adults have become a major target audience for tobacco companies.

According to the researchers, the marketing is “evident in the data, as approximately 20 percent of young adults still smoke cigarettes, and recent national data show that young adults aged 18 to 25 years had the highest prevalence of current tobacco use (40.8 percent) compared with youths (ages 12–17 years) or adults (ages 26 years and older).”

The researchers used data from GFK’s Knowledge Panel (2011–2012), a nationally representative group of 2,144 young adults aged 18 to 34 years, to examine the rate and specific patterns of tobacco product use over time.

Participants were asked questions about the specific time when they started using tobacco products and their overall preferences. The researchers then separated responses into groups by participants’ age, race/ethnicity and state tobacco policies.

Tobacco product use was evaluated at three different points through the use of the following question: "Which, if any, of the following tobacco or nicotine products have you ever used or tried?” Participants were instructed to choose among the following products:

  • Cigarettes
  • Cigars and cigarillos
  • Bidis (a type of cheap cigarette made of unprocessed tobacco wrapped in leaves)
  • Hookahs (an oriental tobacco pipe with a long, flexible tube that draws the smoke through water contained in a bowl),
  • Pipes
  • E-cigarettes
  • Dip or snuff
  • Chewing tobacco and snus (a moist powder tobacco product originating from a variant of dry snuff)

The researchers then separated the groups further to identify the specific type and amount of tobacco products that were preferred by young adults. The groupings were:

  • Non-user: respondents with no reported tobacco use
  • Cigarette only: respondents who only use cigarettes
  • Non-combustible products (NCPs) only: respondents who use NCPs (e.g., e-cigarettes, snus, chewing tobacco, dip or snuff)
  • Other combustible only: respondents who use other tobacco products (e.g., hookahs, pipes, cigars, little cigars, cigarillos and bidis)
  • Poly-users: respondents who reported using more than one type of tobacco product

“Young adulthood marks a critical developmental period, one that often coincides with both the initiation and establishment of regular tobacco use. Prevention efforts directed at this audience will depend on precise understanding of the degree to which young adults are using different tobacco products,” the researchers wrote.

To understand patterns of use and to identify ways to help with prevention, the researchers outlined specifics for each group of young adults who reported tobacco use.

Young adults who were grouped as cigarette-only smokers were most likely to be male, in the older age group of 25–35 years old, to have a high-school education and currently living in a state with high tobacco sales.

Those young adults who were in the other-combustible only group were most likely to be Hispanic, in the younger age group of 18–24 years old and female.

Due to small group size, the researchers chose not to include the data for the non-combustible products group.

Poly-users were more likely to be younger, white and living in state with high tobacco sales, and female.

This “data will help inform program planners and policy makers on the impact of new and alternative tobacco product use among young adults,” the researchers wrote.

The researchers noted limitations of their study. First, data for the use of tobacco products were gathered from participant self-report and could have been biased. Second, they labeled participants as “users” once they reported having used the product. Third, the researchers did not consider the rate of use. Lastly, the number of NCP-only users was small, at 14 participants, therefore it may not be representative of a national sample.

The study was published June 12 in the American Journal of Public Health.

The study was funded in whole or in part with federal funds from the National Institute on Drug Abuse, the Food and Drug Administration and the Department of Health and Human Services.

The authors reported no conflicts of interest.

Review Date: 
June 21, 2014
Last Updated:
June 24, 2014