Article Text

Download PDFPDF

Longitudinal pathways of exclusive and polytobacco cigarette use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)
  1. Kristie A Taylor1,
  2. Eva Sharma1,
  3. Kathryn C Edwards1,
  4. Michael J Halenar1,
  5. Wendy Kissin1,
  6. Karin A Kasza2,
  7. Hannah Day3,
  8. Gabriella Anic3,
  9. Lisa D Gardner3,
  10. Hoda T Hammad3,
  11. Lynn C Hull3,
  12. Maansi Bansal-Travers2,
  13. Jean Limpert3,
  14. Nicolette Borek3,
  15. Heather L Kimmel4,
  16. Wilson M Compton4,
  17. Andrew Hyland2,
  18. Cassandra Stanton1,5
  1. 1 Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
  2. 2 Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
  3. 3 Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
  4. 4 National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
  5. 5 Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
  1. Correspondence to Dr Kristie A Taylor, Behavioral Health and Health Policy, Westat, Rockville, Maryland, USA; KristieTaylor{at}


Objective Cigarettes are the most harmful and most prevalent tobacco product in the USA. This study examines cross-sectional prevalence and longitudinal pathways of cigarette use among US youth (12–17 years), young adults (18–24 years) and adults 25+ (25 years and older).

Design Data were drawn from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US adults and youth. Respondents with data at all three waves (youth, N=11 046; young adults, N=6478; adults 25+, N=17 188) were included in longitudinal analyses.

Results Among Wave 1 (W1) any past 30-day (P30D) cigarette users, more than 60%, persistently used cigarettes across three waves in all age groups. Exclusive cigarette use was more common among adult 25+ W1 P30D cigarette users (62.6%), while cigarette polytobacco use was more common among youth (57.1%) and young adults (65.2%). Persistent exclusive cigarette use was the most common pathway among adults 25+ and young adults; transitioning from exclusive cigarette use to cigarette polytobacco use was most common among youth W1 exclusive cigarette users. For W1 youth and young adult cigarette polytobacco users, the most common pattern of use was persistent cigarette polytobacco use.

Conclusions Cigarette use remains persistent across time, regardless of age, with most W1 P30D smokers continuing to smoke at all three waves. Policy efforts need to continue focusing on cigarettes, in addition to products such as electronic nicotine delivery systems that are becoming more prevalent.

  • non-cigarette tobacco products
  • surveillance and monitoring
  • prevention
View Full Text

Statistics from


  • Contributors KAT and CAS led the conceptual design. KAT drafted the initial manuscript and all authors critically revised it. ES and MJH conducted statistical analysis and all authors contributed to interpretation of the results. All authors approved the work for journal publication and agreed to be accountable for all aspects of the work.

  • Funding This manuscript is supported with Federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services, under a contract to Westat (Contract No. HHSN271201100027C).

  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Department of Health and Human Services or any of its affiliated institutions or agencies.

  • Competing interests WMC reports long-term stock holdings in General Electric Company, 3M Company, and Pfizer Incorporated, unrelated to this manuscript. No financial disclosures were reported by the other authors of this paper.

  • Patient consent for publication Not required.

  • Ethics approval The study was conducted by Westat and approved by the Westat Institutional Review Board. All participants aged 18 and older provided informed consent, with youth participants aged 12–17 providing assent while their parent/legal guardian provided consent.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data from the PATH Study Wave 1 to Wave 3 are available for download as Public Use Files in a public, open access repository ( Conditions of use are available at the website above.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.