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Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey.
Nicotine Tob Res. 2021 08 18; 23(9):1611-1616.NT

Abstract

INTRODUCTION

This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender, and age.

METHODS

Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February-June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the United States. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); noncombustible tobacco (smokeless tobacco, and heated tobacco products [HTPs]); and non-tobacco nicotine products (nicotine vaping products [NVPs], nicotine replacement therapy [NRT], and nicotine pouches).

RESULTS

Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and noncombustible product, with respondents in England reporting the highest levels of use (>26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco.

CONCLUSION

Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation.

IMPLICATIONS

The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and noncombustible nicotine-containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular.

Links

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Authors+Show Affiliations

Li L
Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Borland R
Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Cummings KM
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC.
Gravely S
Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
Quah ACK
Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
Fong GT
Department of Psychology, University of Waterloo, Waterloo, ON, Canada. School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. Ontario Institute for Cancer Research, Toronto, ON, Canada.
Miller CR
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY.
Goniewicz ML
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY.
Le Grande M
Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
McNeill A
Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Shaping Public hEalth poliCies To Reduce ineqUalities and harm (SPECTRUM), UK.

MeSH

AdultElectronic Nicotine Delivery SystemsHumansNicotineSmokersSmokingSmoking CessationSurveys and QuestionnairesTobaccoTobacco ProductsTobacco Use Cessation DevicesUnited StatesVaping

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33693833

Citation

Li, Lin, et al. "Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey." Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, vol. 23, no. 9, 2021, pp. 1611-1616.
Li L, Borland R, Cummings KM, et al. Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey. Nicotine Tob Res. 2021;23(9):1611-1616.
Li, L., Borland, R., Cummings, K. M., Gravely, S., Quah, A. C. K., Fong, G. T., Miller, C. R., Goniewicz, M. L., Le Grande, M., & McNeill, A. (2021). Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey. Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, 23(9), 1611-1616. https://doi.org/10.1093/ntr/ntab040
Li L, et al. Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey. Nicotine Tob Res. 2021 08 18;23(9):1611-1616. PubMed PMID: 33693833.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of Non-Cigarette Tobacco and Nicotine Use Among Current Cigarette Smokers and Recent Quitters: Findings From the 2020 ITC Four Country Smoking and Vaping Survey. AU - Li,Lin, AU - Borland,Ron, AU - Cummings,K Michael, AU - Gravely,Shannon, AU - Quah,Anne C K, AU - Fong,Geoffrey T, AU - Miller,Connor R, AU - Goniewicz,Maciej L, AU - Le Grande,Michael, AU - McNeill,Ann, PY - 2020/12/09/received PY - 2021/03/04/accepted PY - 2021/3/12/pubmed PY - 2021/11/25/medline PY - 2021/3/11/entrez SP - 1611 EP - 1616 JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JO - Nicotine Tob Res VL - 23 IS - 9 N2 - INTRODUCTION: This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender, and age. METHODS: Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February-June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the United States. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); noncombustible tobacco (smokeless tobacco, and heated tobacco products [HTPs]); and non-tobacco nicotine products (nicotine vaping products [NVPs], nicotine replacement therapy [NRT], and nicotine pouches). RESULTS: Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and noncombustible product, with respondents in England reporting the highest levels of use (>26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco. CONCLUSION: Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation. IMPLICATIONS: The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and noncombustible nicotine-containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular. SN - 1469-994X UR - https://www.unboundmedicine.com/medline/citation/33693833/Patterns_of_Non_Cigarette_Tobacco_and_Nicotine_Use_Among_Current_Cigarette_Smokers_and_Recent_Quitters:_Findings_From_the_2020_ITC_Four_Country_Smoking_and_Vaping_Survey_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓10 ↑10]

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