Background: Population models have been developed to evaluate the impact of new tobacco products on the overall population. Reliable input parameters such as longitudinal tobacco use transitions are needed to quantify the net population health impact including the number of premature deaths prevented, additional life years, and changes in cigarette smoking prevalence. Methods: This secondary analysis assessed transition patterns from PATH wave 1 (2013-14) to wave 2 (2014-15) among adult exclusive cigarette smokers, exclusive e-cigarette users, and dual users. Transition probabilities were calculated by taking into account factors including cigarette smoking and e-cigarette use histories and experimental or established use behaviors. Multinomial logistic regression models were constructed to further evaluate factors associated with transition patterns. Results: Differential transition probabilities emerged among study subgroups when taking into account cigarette smoking and e-cigarette use histories and experimental or established use behaviors. For example, overall 45% of exclusive e-cigarette users in wave 1 continued using e-cigarettes exclusively in wave 2. However, we observed approximately 11 to 14% of wave 1 exclusive experimental e-cigarette users continued to use e-cigarette exclusively in wave 2, compared to about 62% of exclusive established e-cigarette users. The history of cigarette smoking and e-cigarette use is another important factor associated with transition patterns. Among experimental e-cigarette users, 7.5% of individuals without a history of cigarette smoking transitioned to exclusive cigarette smoking, compared to 30% of individuals with a history of cigarette smoking. Additionally, 1.3% of exclusive cigarette smokers in wave 1 transitioned to exclusive e-cigarette use, with the highest transition probability (3.7%) observed in the established cigarette smoker with a history of e-cigarette use subgroup.

To ensure quality, consistency, and supply of cigarette products, a manufacturer may change materials, which can affect its product portfolio. Rather than testing each product individually to determine the effect of a change, designed experiments can be conducted using a subset of products, and statistical modeling can be performed to determine the harmful and potentially harmful constituent (HPHC) yields for the remaining products. To demonstrate this, we selected 30 representative cigarette products covering a wide range of tobacco blends, ingredients, and design parameters from a manufacturer's portfolio. Sets of cigarette products used papers produced with one type of manufacturing technology (control products) and two additional cigarette papers (changed products). The physical characteristics of the changed products' papers were similar to the control products but were manufactured using alternative methods, which could lead to differences in their chemical composition. The experiment was controlled to minimize variations among products, manufacturing, and testing. Linear regression was used to model the relationship between HPHC yields of the tested products. Twelve randomly selected products were used for validation by comparing predicted to measured yields. Model predictions were robust; differences between measured and predicted values were within standard repeatability limits, demonstrating the feasibility of this approach.https://doi.org/10.21423/jrs-v07hannel

Background: Lifetime established use criteria are essential to distinguish tobacco product experimental and established users; however, these criteria are not as well defined for some tobacco product categories. The objective of this analysis is to examine various lifetime use criteria to facilitate an objective characterization of experimental versus established use behaviors. Methods: Our analyses were conducted using the Population Assessment of Tobacco and Health (PATH) Study Waves 1 to 5 datasets. We first examined the level of agreement between non-numerical (having smoked/used the product fairly regularly) and numerical ( having smoked/used the product 20/50/100 times (e.g., use occasions) or product units) lifetime established use criteria among ever-, current-, and former-tobacco product users of various tobacco products. Logistic regression models were constructed to compare demographics, socioeconomic status, and tobacco product use patterns among current experimental versus current established users. Longitudinal analyses were performed to investigate the association between numerical or non-numerical criteria and discontinuation of past 30-day use at follow-up waves. Results: For tobacco product categories other than cigarette, we identified the following numerical thresholds as the objective characterization of established use: 50 for cigars and pipe products and 20 times for hookah, electronic nicotine products, smokeless, snus, and dissolvable tobacco products, based on level of agreement with the non-numerical criterion (kappa coefficients ranging from 0.3 to 0.6) and also with consideration of existing consensus. Significant differences were observed in demographics, socioeconomic status, tobacco product use and discontinuation of past 30-day use patterns when comparing current experimental and current established users with either non-numerical or numerical criteria. Conclusions: This study is the first PATH data analysis to derive quantitative thresholds of lifetime established use criteria to characterize experimental versus established use behaviors. Consistent applications of the lifetime established use criteria in data analysis and reporting would improve harmonization in research findings.

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