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

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.

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.

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

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.