Clinical Pearls & Morning Reports
Published January 25, 2017
Smoking is responsible for more U.S. deaths annually than the acquired immunodeficiency syndrome, use of alcohol and illegal drugs, car accidents, murders, and suicides combined. Noncigarette tobacco products are rapidly evolving, and their effect on population-level health is unknown. Use of electronic cigarettes (e-cigarettes), cigars, smokeless tobacco, and hookah (waterpipe) has risen sharply in the past decade, and the use of two or more tobacco products has increased in recent years, especially among young adults. A new Review Article explains.
Q: What is the PATH Study?
A: The Family Smoking Prevention and Tobacco Control Act of 2009 gave the Food and Drug Administration (FDA) broad regulatory authority over the manufacture, marketing, and distribution of regulated tobacco products to protect the health of the U.S. population. The FDA Center for Tobacco Products uses a robust scientific evidence base to inform and assess the effect of its tobacco regulatory activities. In 2011, the Population Assessment of Tobacco and Health (PATH) Study was established to generate longitudinal epidemiologic data on tobacco-use behavior and health in the U.S. population. Estimates of the prevalence of tobacco use among adults and youths, on the basis of Wave 1 (2013–2014) of the PATH Study, are presented according to type of tobacco product and category of tobacco use. A new Review Article explains.
Q: How does the PATH Study differ from other national studies of tobacco use?
A: In contrast to other national studies that have been used for the surveillance of tobacco use, the PATH Study uses a detailed assessment of tobacco-use behaviors, the inclusion of biomarkers, and a longitudinal design in a comprehensive effort to document tobacco use. Specifically, the design of the PATH Study will allow for examination of between-person differences and within-person changes over time in patterns of use of existing and emerging tobacco products, exposures and related biomarkers, risk perceptions, and health conditions potentially related to tobacco use. An additional feature of the PATH Study is the use of pictures to assist respondents in answering questions about their awareness and use of noncigarette tobacco products. Respondents in national surveys may not always clearly distinguish between types of tobacco products (e.g., filtered cigars vs. cigarettes, or snus pouches vs. other smokeless tobacco products), which could affect estimates of prevalence.
A: Initial (Wave 1) findings from the PATH Study, a nationally representative, longitudinal study of tobacco use and health in the United States, indicate that more than one quarter of adults 25 years of age or older and nearly 38% of young adults (18 to 24 years of age) were current users of a tobacco product in 2013 and 2014. A total of 15% of youths 15 to 17 years of age and nearly 3% of youths 12 to 14 years of age had used at least one type of tobacco product in the previous 30 days. Although cigarette use was the most prevalent in each age group, approximately 40% of tobacco users used at least two types of products, with cigarettes plus e-cigarettes being the most common combination of products used by adults and by youths.
A: Findings showed substantial differences in tobacco use according to demographic characteristics. Among adults, tobacco use was generally higher among younger adults, men, members of racial minorities, members of sexual minorities, those with lower educational attainment and lower household income, and those living in the South or Midwest than among their counterparts. Among youths, the prevalences of ever use and use in the previous 30 days were higher among older youths, male youths, and members of sexual minorities than among their counterparts. Although these findings are generally consistent with those from other studies, the PATH Study data extend these prevalence estimates for a wide array of tobacco products.