Sociodemographic Patterns of Exclusive, Dual, and Polytobacco Use Among U.S. High School Students: A Comparison of Three Nationally Representative Surveys.

Introduction:
This article examines sociodemographic patterns of exclusive, dual, and polytobacco use among U.S. high school students using multiple national surveys. The study aims to classify tobacco products into four groups and create 16 categories of non/exclusive/dual/polytobacco use within the past 30 days. The weighted prevalence of these categories is then calculated by sex and race/ethnicity, as well as parental education and income for the Population Assessment of Tobacco and Health (PATH) Wave 4 survey.

Key Points:

* The study uses three national youth surveys: PATH Wave 4 (2016-17), 2017 YRBS, and 2017 NYTS.
* Tobacco products are classified into four groups: ENDS, CCs, OCTPs, and STPs.
* The study creates 16 categories of non/exclusive/dual/polytobacco use and calculates weighted prevalence by sex, race/ethnicity, parental education, and income.
* Results show that ENDS is the most prevalent exclusive-use product, and as income and parental education levels increase, the prevalence of exclusive CC use decreases while the prevalence of exclusive ENDS use increases.
* By sex, exclusive, dual, and poly STP use are more common for males, while exclusive CC use is more common for females.
* By race/ethnicity, NH Whites had a higher prevalence of exclusive ENDS use and ENDS/CC dual use than NH Blacks.
* The study provides a probable range of tobacco product use prevalence among youth and quantifies differences in patterns of tobacco product use by key sociodemographic groups.

Main Message:
Understanding sociodemographic patterns of tobacco use can help identify groups who may be at greater risk for tobacco-related health outcomes. The study found that ENDS is the most prevalent exclusive-use product and that as income and parental education levels increase, the prevalence of exclusive CC use decreases while the prevalence of exclusive ENDS use increases. These findings can inform regulatory measures aimed at reducing tobacco use among high school students, particularly those who are at greater risk for tobacco-related health outcomes.

Cho B, Hirschtick JL, Usidame B, et al. Sociodemographic Patterns of Exclusive, Dual, and Polytobacco Use Among U.S. High School Students: A Comparison of Three Nationally Representative Surveys. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2021;68(4):750-757. doi:10.1016/j.jadohealth.2020.11.019