Behavioral heterogeneity among cigarette and e-cigarette dual-users and associations with future tobacco use: Findings from the Population Assessment of Tobacco and Health Study.

Introduction:
This text is a scientific article that examines the behavioral heterogeneity among cigarette and e-cigarette dual-users and its associations with future tobacco use behaviors. The study uses data from the Population Assessment of Tobacco and Health Study and categorizes dual-users into four groups based on the frequency with which they use each product. The study identifies sociodemographic correlates of group membership and the prevalence of completely switching to e-cigarettes and quitting both products by Wave 3.

Key Points:

* The study finds that dual-users who smoke cigarettes every day and use e-cigarettes some days are the majority and more likely to have lower education.
* The study finds that dual-users who use some day smoking and daily e-cigarette use are most likely to have completely switched to e-cigarettes by Wave 3.
* The study finds that dual-users who smoke and use e-cigarettes some days are most likely to have completely quit tobacco by Wave 3.
* The study finds that dual-users who have higher education or income are more likely to have completely switched to e-cigarettes or quit tobacco use by Wave 3.
* The study uses data from the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of U.S. adults and adolescents.
* The study uses a fourfold classification scheme of dual-use that reflects the heterogeneity inherent specifically in dual-use and in tobacco use more generally.
* The study uses multivariate logistic regression to examine how the adjusted odds of harm reduction and tobacco cessation at Wave 3 varied by dual-use behaviors at Wave 1 while controlling for sociodemographics characteristics.

Main Message:
The study highlights the importance of considering the variation in dual-use behaviors and its associations with future tobacco use behaviors. The study finds that dual-users who have higher education or income are more likely to engage in plausibly less harmful dual-use behaviors, which are more strongly associated with harm reduction and cessation behaviors. The study suggests that future research should consider this variation to more accurately characterize the public health impact of dual-use. The study also highlights the importance of considering the potential impact of dual-use on smoking disparities and ensuring equitable impact when designing, implementing, and evaluating harm reduction policies.

Baig SA, Giovenco DP. Behavioral heterogeneity among cigarette and e-cigarette dual-users and associations with future tobacco use: Findings from the Population Assessment of Tobacco and Health Study. Addictive behaviors. 2020;104:106263. doi:10.1016/j.addbeh.2019.106263