Cho J, Goldenson NI, Stone MD, et al. (2018). Characterizing polytobacco use trajectories and their associations with substance use and mental health across mid-adolescence. Nicotine and Tobacco Research. 20(Suppl. 1): S31-S38. doi: 10.1093/ntr/ntx270
Researchers recruited 3,393 students entering 9th grade at 10 high schools in the Los Angeles metropolitan area to complete surveys assessing use of tobacco products, mental health, and substance use to determine trajectories of multimodal tobacco use and relationships between trajectory, mental health, and substance use. Participants completed a survey of past 6-month tobacco consumption using combustible cigarettes, e-cigarettes, and hookahs at baseline and 6, 12, 18, and 24 months. At baseline and 24 months, participants completed assessments of depression, anxiety, and attention-deficit hyperactive disorder (ADHD) symptoms and number of days of alcohol, marijuana, and illicit substance use in the past 30 days. Researchers found 3 distinct patterns of multimodal tobacco use. “Tobacco nonusers” (n=2,291) had a tobacco use prevalence less than 3%, regardless of mode of use and consistent across time points. “Poly-product users” (n=920) had a low prevalence of combustible cigarette use at baseline that increased over time, while prevalence of e-cigarette and hookah use decreased over time. “Chronic poly-product users” (n=182) had the highest prevalence of use by all 3 modes and increased the prevalence of combustible cigarette and e-cigarette use over time. Poly-product users and chronic poly-product users reported more days of alcohol, marijuana, and illicit drug use and were more likely to report clinical depression, anxiety, and ADHD symptoms than tobacco non-users at 24 months. Chronic poly-product users reported significantly more days of alcohol, marijuana, and illicit drug use than poly-product users.