The first nicotine product tried is associated with current multiple nicotine product use and nicotine dependence among a nationally representative sample of U.S. youths.

Introduction:
This text provides an analysis of data from the Population assessment of Tobacco and health (PaTh) Study Restricted-Use Files. The study focuses on the first nicotine product tried by youth and its association with future multiple product use and nicotine dependence. The analysis uses data from Wave 1 and Wave 4 of the PaTh study and controls for age of first product tried. The study aims to answer the question of how a youth's first product tried impacts their nicotine product use three years later.

Key Points:

* The study uses data from the PaTh study, which consists of a representative sample of the U.S. civilian, non-institutionalized population aged 12 years and older.
* The study focuses on the first nicotine product tried by youth and its association with future multiple product use and nicotine dependence.
* The analysis is based on data from Wave 1 and Wave 4 of the PaTh study and controls for age of first product tried.
* The study finds that the first nicotine product tried is associated with demographic factors such as sex, race, parent education, and urbanicity.
* The study also finds that first trying smokeless tobacco is associated with a greater likelihood of multiple product use and higher nicotine dependence scores.
* The study uses a multivariable model that consists of two mathematical components modeled simultaneously: part 1 is a multivariable logistic regression with any symptom of nicotine dependence as the dependent variable, and part 2 is a multivariable regression with the continuous nicotine dependence score as the dependent variable among those with any symptom of nicotine dependence.
* The study adjusts for demographic factors such as sex, race, parent education, and urbanicity.

Main Message:
The study highlights the importance of understanding the first nicotine product tried by youth and its association with future multiple product use and nicotine dependence. The study finds that first trying smokeless tobacco is associated with a greater likelihood of multiple product use and higher nicotine dependence scores. These findings suggest that tailored interventions for smokeless tobacco users may be necessary to prevent multiple product use and nicotine dependence among youth. The study also emphasizes the need for clinicians and public health workers to communicate the health risks associated with youths' pattern of use.

Simon P, Buta E, Jackson a, et al. The first nicotine product tried is associated with current multiple nicotine product use and nicotine dependence among a nationally representative sample of U.S. youths. Preventive medicine. 2023;169:107437. doi:10.1016/j.ypmed.2023.107437