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Open Access Heat-not-burn Tobacco Products and the Increased Risk for Poly-tobacco Use

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This article is Open Access under the terms of the Creative Commons CC BY-NC-ND licence.

Objectives: In this study, we tested the use of ecigarette, cigarette, and dual use of both as predictors of heat-not-burn (HNB) tobacco product use onset among young adults, and examined common predictors of smoking cessation as predictors of HNB product use. Methods: We collected data from 2229 young adults [mean age = 21.1 (SD = 2.1); 55% women] in Hawaii, at 2 time-points 6 months apart. Results: Current cigarette-only use was the strongest concurrent predictor of HNB product use, followed by dual use, and ecigarette-only use. Among HNB product never users at Wave 1, dual and ecigarette-only use at Wave 1 significantly predicted HNB product use onset at Wave 2. Among cigarette smokers who had never used an HNB product at Wave 1, current use of ecigarette for help with smoking cessation predicted increased odds of HNB product use at 6-month follow-up. Conclusions: Although promoted as a safer alternative for exclusive cigarette smokers, HNB products may increase the risk of dual or poly-tobacco product use among young adults, including current exclusive e-cigarette users. Surveillance of HNB product use as a modified risk tobacco product may need to consider the effects of HNB products on poly-tobacco use among young people.

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Keywords: HEAT-NOT-BURN TOBACCO PRODUCTS; POLY-TOBACCO USE; YOUNG ADULTS

Document Type: Research Article

Affiliations: 1: Pallav Pokhrel, Associate Professor, Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States;, Email: [email protected] 2: Thaddeus A. Herzog, Associate Professor, Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States 3: Crissy T. Kawamoto, Project Manager, Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States 4: Pebbles Fagan, Professor, Center for the Study of Tobacco, Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States

Publication date: January 1, 2021

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

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