Examining Adolescent Polytobacco Use

Purpose: Sales of cigarettes are declining whereas sales of other tobacco products, such as cigars and snus are increasing. Other tobacco products are marketed as safer alternatives to cigarettes, increasing concern that concurrent use of multiple products will gain popularity, particularly among adolescents. Yet, little research examines polytobacco use. The purpose of the present study was to examine polytobacco use in adolescents and determine their risk perceptions of tobacco products in comparison with users of one tobacco product. Methods: Data were from the 2011 Texas Youth Tobacco Survey, in which 6,152 6^th-12^th grade students participated (50.5% male; 48% white, 38.8% Hispanic). Polytobacco use was defined as using two or more of the following in the past 30 days: cigarettes, chewing tobacco, snus, hookah/waterpipe, cigars/cigarillos/little cigars. Students were asked four questions regarding how dangerous it is (1=very dangerous; 4=not dangerous at all) for a person their age to use cigarettes, chewing tobacco, cigars, and snus. Results: 82% of adolescents did not use any tobacco products in the past 30 days, 6.7% used one product, 6.3% used two, 2.6% used three, 1.4% used four, and 1% used all five. 66% of polytobacco users were male, 77% were in high school, and most were white (43%) or Hispanic (40%). Results from one-way ANOVAs indicated that polytobacco users perceived significantly less danger in using each tobacco product compared with users of one tobacco product. Conclusion: Given differences between exclusive and polytobacco users, tobacco prevention and intervention strategies specific to subgroups of adolescents are needed.