This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 20-039. This project directly addresses the research priority areas that focus on understanding the knowledge, attitudes, and behaviors that contribute to the age of initiation of co-use of multiple tobacco products (TP) and binge drinking in youth, and their associated factors. Given the tobacco product combinations that are most prevalent among youth, this project focuses on (i) cigarettes, e-cigarettes (c-ecig) and binge drinking, and (ii) cigarettes, cigarillos (c-c) and binge drinking to improve public health outcomes and prevent disease, such as cancer. For the purposes of this proposal, co-use is defined as past 30-day use of all products, simultaneously, in the same wave in the Population Assessment of Tobacco and Health (PATH) study. Prospectively estimating the age of initiation, defined as first past 30-day report of multiple TP use and binge drinking among youth who reported never use of the three products at their first wave of participation is innovative given the research gap in what we know about their co-use. Our supplemental study is a prospective secondary analysis of the first four waves of PATH among U.S. youth (12-17 years old) who reported never use of cigarettes, e- cigarettes, cigarillos and binge drinking, at their first wave of participation in PATH. The parent grant has three aims.
Aim 1 : Among youth ages 12-17 years old who are never users of TPs at wave 1, to estimate prospectively their age of initiation of TPs and to identify the risk factors associated with the age of initiation of cigarettes and each one of the NCTPs: e-cigarettes, cigars, hookah, and smokeless tobacco.
Aim 2 : same as aim 1 but among young adults ages 18-24 years old who are never users of TPs at wave 1.
Aim 3 : Among youth and young adults ages 12-24 who are never users of TPs at wave 1, to identify the trajectories and transitions in the onset of TPs across time, from waves 1 to 4, and to identify the risk factors associated with these trajectories and transitions. This supplement adds Aim 4: Among youth ages 12-17 years old who are never users of these TPs and alcohol at their first wave of participation in PATH, to prospectively estimate their age of initiation (i.e., first report) of (i) past 30-day use of c-ecig and binge drinking, and (ii) past 30-day use of c-c and binge drinking, using survival analyses, and to identify the risk factors associated with their co-use. We plan to explore a variety of socio-demographic, interpersonal and intrapersonal factors with these outcomes. Few studies can estimate the age of initiation of co-use with longitudinal data that span youth and young adults. This includes tracking outcomes and their age of initiation of underage (i.e., youth) participants that become young adults in PATH. This project strengthens the evidence regarding co-use of multiple TPs and binge drinking using a national longitudinal study and takes advantage of contemporary data that reflects the evolving TP landscape. Also, the results are essential for tobacco control as recent studies indicate that the use of TPs with alcohol increases the amount of use of both and may explain future cancer risk and deaths.
With a new generation of tobacco products on the market the parent grant proposed to describe the age of initiation, changing patterns of tobacco use behaviors, and correlates of tobacco use among U.S. youth (12-17 years old) and young adults (18-24 years old). The current project is providing new information about the age of initiation, patterns and correlates of cigarettes, e- cigarettes, little/filtered cigars/cigarillos/large cigars, hookah, smokeless tobacco and the use of any of these in 4 waves of a national sample of youth (12-17 years old) and young adults (18-24 years old) in the context of the contemporary tobacco product landscape. In the administrative supplement we will estimate the age of initiation of (i) past 30-day use of cigarette, e-cigarette and binge drinking, as well as (ii) past 30-day use of cigarette, cigarillo, and binge drinking, among U.S. youth (12-17 years old).