Susceptibility to tobacco product use among youth in wave 1 of the population Assessment of tobacco and health (PATH) study

The purpose of this study was to investigate susceptibility and ever use of tobacco products among adolescents and young adults in the US. Cross-sectional analysis of Wave 1(2013-2014) adolescent (12-17 year-olds; n = 13,651) and young adult (18-24 year-olds; n = 9112) data from the nationally-representative Population Assessment of Tobacco and Health (PATH) Study was conducted. At 12 years, 5% were ever tobacco users and 36% were susceptible to use. Seventy percent were susceptible at age 17 years, and the same proportion were ever users at age 22 years. Susceptibility levels were comparable for cigarettes and e-cigarette (28.6% and 27.4%, respectively), followed by hookah (22.0%), pipes (17.5%), cigars (15.2%), and smokeless tobacco (9.7%). Non-Hispanic (NH) Black (Adjusted Odds Ratio [ORadj] = 1.36; 95% Confidence Limit [CL], 1.18-1.56) and Hispanic (ORadj = 1.34: 95% CL,1.19-1.49) adolescent never- users were more likely to be susceptible to future use of a tobacco product than NH Whites. Susceptibility was higher with age (15-17 yrs. vs 12-14 yrs.: ORadj = 1.69; 95% CL, 1.55-1.85) and parental education (college graduates vs less than HS education: ORadj = 1.22, 95% CL, 1.08-1.39). Compared to exclusive users of hookah, cigars, or smokeless products, larger proportions of exclusive e-cigarette ever users were also susceptible to cigarette use. Among adolescents, lower levels of ever use of tobacco products are often counterbalanced by higher levels of susceptibility for future use, which may suggest delayed initiation in some groups. Ever users of a given tobacco product were more susceptible to use other tobacco products, putting them at risk for future multiple tobacco product use.