Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014–2016

Introduction:
This text is a research paper that examines the age of initiation of five tobacco product categories among US middle and high school students. The study uses data from the National Youth Tobacco Survey (NYTS) from 2014-2016 and assesses the age of reported first use of each product among ever-users, overall and by sex and race/ethnicity. The study also examines current daily use, past 30-day use, feelings of craving tobacco, and time to first tobacco use after waking by age of first use.

Key Points:

* The study included 19,580 respondents who reported ever using at least one of the five tobacco product categories: e-cigarettes, cigarettes, cigars, smokeless tobacco, and hookah.
* Among ever-users, the weighted median age for first use was 12.6 years for cigarettes, 13.8 years for cigars, 13.4 years for smokeless tobacco, 14.1 years for hookah, and 14.1 years for e-cigarettes.
* Initiating use of these tobacco products at age 13 or younger was associated with greater current use of the respective product and nicotine dependence compared with initiating use at age 14 or older.
* The study is the first to report age of initiation of cigars, smokeless tobacco, and hookah among US middle and high school students.
* The study controlled for sex, race/ethnicity, current age, survey year, and current use of other tobacco products.
* The study found that first tobacco use at age 13 or younger is associated with current daily and past 30-day use of non-cigarette tobacco products, and with the development of nicotine dependence among youth ever-users.

Main Message:
The main message of this text is that proven tobacco prevention interventions that reach early adolescents are important to reduce overall youth tobacco use. The study found that initiating use of tobacco products at age 13 or younger is associated with greater current use of the respective product and nicotine dependence. Therefore, it is crucial to implement effective tobacco prevention interventions that target early adolescents to reduce the burden of tobacco use among youth. This message is particularly important in light of the increasing popularity of non-cigarette tobacco products, such as e-cigarettes, among youth.

Sharapova, Saida, Carolyn Reyes-Guzman, Tushar Singh, Elyse Phillips, Kristy L Marynak, and Israel Agaku. “Age of Tobacco Use Initiation and Association with Current Use and Nicotine Dependence among US Middle and High School Students, 2014–2016.” Tobacco Control 29, no. 1 (January 2020): 49–54. https://doi.org/10.1136/tobaccocontrol-2018-054593.