Work

Guidance for the Methodological Challenges of Polytobacco Use in Tobacco Regulatory Science

Year: 2025

Type: article

Abstract: Concurrent use of multiple tobacco products (polytobacco use) is important to understand because of its effects on health and behavioral outcomes across the lifespan.Polytobacco use includes the use of more than one tobacco product within a specified time frame.Dual use typically refers to the use of only two products concurrently, often referring to the use of combustible cigarettes and electronic cigarettes (e-cigarettes) or two combustible products, such as cigarettes and little cigars.Although dual use is a subset of polytobacco use, the focus of this article is on the use of three or more products concurrently.Across nationally representative surveys, approximately 0.9% to 5.1% of high school-aged students in 2017 reported polytobacco use.Although polytobacco use at the population level is lower among adults than among adolescents, polytobacco use accounts for 16.7% of product use among tobacco users.1,2 Polytobacco use among adolescents and young adults, in some cases, may reflect more regular use and follows a similar path to negative social, physical, and mental health outcomes as seen with polysubstance use.3,4 Alternatively, polytobacco use may reflect low-frequency experimentation or transitory product use.Understanding how patterns of polytobacco use are associated with escalation and nicotine dependence over time as opposed to transitory behaviors such as experimentation is important when informing prevention strategies and weighing the net public health impact of using multiple tobacco products.Moreover, motivations for polytobacco use could include the use of one tobacco product to reduce the use of another tobacco product, bypass smoke-free policies, or avoid stigma or disapproval from peers, partners, or parents.Understanding motivations for polytobacco use can help shape intervention efforts to reduce tobacco use harms.5 Knowledge of patterns and trajectories of polytobacco use can help guide tobacco product regulations.We examine major methodological challenges to measuring polytobacco use and make recommendations based on an evaluation of patterns of polytobacco use and associated health outcomes.Currently, guidance on best practices or recommended approaches for defining, measuring, and analyzing polytobacco use is lacking.We provide guidance for 1367589P HRXXX10.

Source: Public Health Reports

DOI: 10.1177/00333549251367589