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J Adolesc Health. 2018 Oct;63(4):413-420. doi: 10.1016/j.jadohealth.2018.04.011. Epub 2018 Jul 9.

Youth or Young Adults: Which Group Is at Highest Risk for Tobacco Use Onset?

Author information

1
Department of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Cheryl.L.Perry@uth.tmc.edu.
2
Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Adriana.Perez@uth.tmc.edu.
3
Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Meagan.A.Bluestein@uth.tmc.edu.
4
Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Nicholas.J.Garza@uth.tmc.edu.
5
Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Udoka.C.Obinwa@uth.tmc.edu.
6
Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Christian.D.Jackson@uth.tmc.edu.
7
Tobacco Center of Regulatory Science on Youth and Young Adults, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas. Electronic address: Stephanie.L.Clendennen@uth.tmc.edu.
8
Health Behavior and Health Education in the Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, Texas. Electronic address: alexandra.loukas@austin.utexas.edu.
9
Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health in Austin, Austin, Texas. Electronic address: Melissa.B.Harrell@uth.tmc.edu.

Abstract

PURPOSE:

Historically, adolescence has been regarded as the time when most tobacco use initiation occurs. This study examines the initiation of tobacco product use, including cigarettes, e-cigarettes, cigar products, and hookah, among contemporary youth and young adults, to determine whether the developmental timing (youth vs. young adulthood) of initiation has changed.

METHODS:

Three cohort studies were used to examine the onset of ever use and current (past 30 days) use of each tobacco product among never-using youth (11 to <17 years) and young adults (18-24 years) at baseline (2013-2015) to one-year follow-up (2015-2016). These studies include the national Population Assessment of Tobacco and Health Study, and two Texas cohort studies, the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS), and the Marketing and Promotions Across Colleges in Texas (M-PACT) project. Estimations of onset were computed using generalized linear mixed models for TATAMS and M-PACT. The rates of initiation in Population Assessment of Tobacco and Health Study were compared to standardized incidence rates from TATAMS to M-PACT.

RESULTS:

Young adults had significantly higher incidence rates than youth to initiate ever and current use of each/all tobacco products for all comparisons.

CONCLUSIONS:

These findings extend prior research on the timing of the onset of tobacco use by using longitudinal analyses from three contemporary cohort studies to include not just cigarettes, but also e-cigarettes, cigar products, and hookah. Among those who were never-users of tobacco products, young adults began to ever and currently use all tobacco products more than youth in these samples, a marked departure from prior decades of research.

KEYWORDS:

Adolescents; Cigarettes; Cigars; Current use; E-cigarettes; ENDS; Hookah; Initiation; Young adults; Youth

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