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N Engl J Med. 2017 Jan 26;376(4):342-353. doi: 10.1056/NEJMsa1607538.

Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014.

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From the Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (K.A.K., M.L.G., M.B.-T., M.J.T., A.J.H.); the Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring (B.K.A., N.B., J.K., C.T., Y.-C.C., L.Y., N.P.-C., D.M.B., C.L.B.), National Institute on Drug Abuse (K.P.C., V.R.G., W.M.C.) and Division of Cancer Control and Population Sciences, National Cancer Institute (A.R.K.), National Institutes of Health, Bethesda, and Westat (K.T., E.S.) and Kelly Government Solutions (V.R.G.), Rockville - all in Maryland; the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (K.M.C.); and the Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC (J.L.P.).



Noncigarette tobacco products are evolving rapidly, with increasing popularity in the United States.


We present prevalence estimates for 12 types of tobacco products, using data from 45,971 adult and youth participants (≥12 years of age) from Wave 1 (September 2013 through December 2014) of the Population Assessment of Tobacco and Health (PATH) Study, a large, nationally representative, longitudinal study of tobacco use and health in the United States. Participants were asked about their use of cigarettes, e-cigarettes, traditional cigars, cigarillos, filtered cigars, pipe tobacco, hookah, snus pouches, other smokeless tobacco, dissolvable tobacco, bidis, and kreteks. Estimates of the prevalence of use for each product were determined according to use category (e.g., current use or use in the previous 30 days) and demographic subgroup, and the prevalence of multiple-product use was explored.


More than a quarter (27.6%) of adults were current users of at least one type of tobacco product in 2013 and 2014, although the prevalence varied depending on use category. A total of 8.9% of youths had used a tobacco product in the previous 30 days; 1.6% of youths were daily users. Approximately 40% of tobacco users, adults and youths alike, used multiple tobacco products; cigarettes plus e-cigarettes was the most common combination. Young adults (18 to 24 years of age), male adults and youths, members of racial minorities, and members of sexual minorities generally had higher use of tobacco than their counterparts.


During this study, 28% of U.S. adults were current users of tobacco, and 9% of youths had used tobacco in the previous 30 days. Use of multiple products was common among tobacco users. These findings will serve as baseline data to examine between-person differences and within-person changes over time in the use of tobacco products. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration.).

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