Age of Initiation of Tobacco Products Among USA Youth and Young Adults

Estimating the age of onset of tobacco product initiation, transition or trajectories of patterns of use, and correlates of use among U.S. youth and young adults could be informative. This study involves a prospective secondary analysis of the first three waves of the Population Assessment of Tobacco and Health (PATH) Study among U.S. youth (aged 12-17 years) and young adults (aged 18-24 years) who reported never use at Wave 1. Use of the following tobacco products will be analyzed: cigarettes, e-cigarettes, cigars (traditional cigars, cigarillo, and filtered cigars), hookah, and smokeless tobacco. Seven outcomes will be evaluated for each product: age to first report ever or past 30-day use, age to become susceptible to use, age to be an established user (i.e. ever use fairly regularly), age to first report dual/poly use, age to report first use of a flavored product, and age of ever combustible use. Study aims are: (1) among youth who were never users at Wave 1, to estimate their age of initiation of tobacco products and to identify the risk factors associated with age of initiation of each product; (2) among young adults who were never users at Wave 1, to estimate their age of initiation of tobacco products and to identify the risk factors associated with age of initiation of each product; and (3) among all participants, to identify trajectories and transitions in the onset of tobacco product use across time and to identify associated risk factors. Researchers will explore socio-demographic, interpersonal, intra-personal, social, and environmental factors potentially associated with the age of initiation of the different products. This study will provide new data regarding tobacco product use trajectories among youth and young adults.