19% of teens use more than one kind of tobacco

"Adolescents are not just using cigarettes. They are using cigarettes and other tobacco products—some of which are new and unregulated," says Sarah Kowitt. (Credit: iStockphoto)

Cigarette use among adolescents has declined substantially over the past few decades, but use of tobacco products such as snus, e-cigarettes, and hookah continue to grow in popularity.

A new study of more than 4,000 high school students in North Carolina finds that one-third, or 29.7 percent, say they use tobacco. Further, among all students, 19.1 percent say they use more than one kind of tobacco, compared to 10.6 percent who report use of only one product.

The findings are published in the International Journal of Environmental Research and Public Health.

“This study illustrated how much of a problem poly-tobacco use really is among adolescents,” says lead author Sarah Kowitt, a third-year doctoral student in the Health Behavior department at the University of North Carolina Gillings School of Global Public Health.

“Adolescents are not just using cigarettes. They are using cigarettes and other tobacco products—some of which are new and unregulated. We need to be thinking about how to tackle this problem from multiple dimensions, garnering support from policy, research, and practice.”

[Teen smokers use e-cigarettes, but not to quit]

The most common combination of products among these “poly-users” is cigarettes and cigars or cigarillos (little cigars), followed by cigarettes and e-cigarettes. A 2012 study found that 21.7 percent of high schoolers had ever used and 8.8 percent were currently using one or more of these products.

Additionally, only 68.8 percent of poly-users say they believe that “all tobacco products are dangerous,” compared to 81.5 percent of single-users and 91.4 percent of non-users. Poly-users are also significantly more likely than single-users or non-users to report that they believe that “smoking cigarettes makes young people look cool” and that “young people who smoke cigarettes have more friends.” Males are significantly more likely than females to use one or more tobacco products.

The researchers suggest that several reasons may be behind this high rate of poly-tobacco use in North Carolina students. North Carolina is a major tobacco-growing state and has one of the lowest cigarette taxes in the country. The state also lacks comprehensive tobacco-free workplace policies, and money earmarked for tobacco use prevention programs has been diverted to other programs during recent budget cuts.

These findings could have major implications for communication campaigns, policy efforts, and future research for prevention, regulation, and control of poly-tobacco use among adolescents.

Source: UNC-Chapel Hill