Prospective estimation of the age of initiation of cigarettes among young adults (18–24 years old): Findings from the Population Assessment of Tobacco and Health (PATH) waves 1–4 (2013–2017)

Abstract

Objectives To prospectively estimate the age of cigarette initiation among young adults (18–24 years old) who were never cigarette users at their first wave of adult study participation overall, by sex, and by race/ethnicity given recent increases in cigarette initiation occurring in young adulthood. Methods Secondary analyses were conducted using the PATH restricted-use adult datasets among young adult never users of cigarettes in waves 1–3 (2013–2016) with outcomes followed-up in waves 2–4 (2014–2017). Interval censoring survival methods were used to estimate the age of initiation of (i) ever, (ii) past 30-day, and (iii) fairly regular cigarette use. Among never cigarette users when they first entered the adult study, interval censoring Cox proportional hazard models were used to explore differences in the estimated age of initiation of the three cigarette use outcomes by sex and by race/ethnicity, controlling for the effect of previous e-cigarette use and the total number of other tobacco products ever used (0–5 products) before cigarette initiation outcomes. Results Among the young adults who were never cigarette users at their first wave of adult participation, the highest increase in cigarette initiation occurred between 18 and 19 years old. By age 21, 10.6% (95% CI: 9.5–11.7) initiated ever cigarette use, 7.7% (95% CI: 6.1–8.1) initiated past 30-day of cigarette use, and 1.9% (95% CI: 1.4–2.5) initiated fairly regular cigarette use. After controlling for other tobacco products: (a) males were 83% more likely to initiate past 30-day cigarette use at earlier ages than females; (b) Hispanic and Non-Hispanic Black young adults had increased risk to initiate past 30-day cigarette use at earlier ages than Non-Hispanic White young adults (62% and 34%, respectively). Conclusions The substantial amount of cigarette initiation among young adults reinforces the need for prevention strategies among this population. Although, interventions are needed for all young adult populations, strategies should target 18-21-year-olds, with potentially differential prevention targets by sex and by race/ethnicity.

Age of Onset of Susceptibility to Different Tobacco Products Among Non-Susceptible US Young Adults: Findings from the Population Assessment of Tobacco and Health Study Waves 2-4 (2014-2017)

“…Tobacco Use Insights n n tobacco products other than cigarettes is increasing in young adults. [4][5][6][7][8][9]55 Our results stand in contrast to previous research regarding the particular products that exhibited sex differences in the age of susceptibility onset. Specifically, a previous nationally representative sample of young adults (18-24 years old) found that males had increased prevalence of susceptibility to cigarette use compared with females (25.6% and 14.1%, respectively), 24 while we found no differences in the age of susceptibility onset between males and females.…”

“…However, these campaigns are typically targeted toward youth instead of young adults, 3 despite the fact that an increasing amount of tobacco product initiation occurs during young adulthood. [4][5][6][7][8][9] Thus, identifying the age at which young adults become susceptible to tobacco product use is critical for prevention efforts.…”

Sociodemographic predictors for smoking persistence among young males in Indonesia

“…Previous studies have underlined the importance of age of first smoking as a predictor of smoking persistence. The high persistence of smoking in young adults begins as teenagers when they first try and has become a problem for millions of young adults today 21 . This study found that young males who first tried smoking as adolescents were influenced by their closest friends who smoked and shared their habits.…”

Longitudinal Transition Patterns of Tobacco Use Among Youth and Young Adults Never Tobacco Product Users: Findings From the Population Assessment of Tobacco and Health Study, 2014-2019

“…Tobacco use remains high among youth and young adults despite recent efforts to curb tobacco initiation in the context of the evolving tobacco product landscape [1][2][3][4][5][6][7] . A recent report of the 2021 National Youth Tobacco Survey (NYTS) indicated that 19.4%, 8.1% and 2.8% of middle and high school students, had ever used e-cigarettes, cigarettes, and hookah, respectively 1 .…”

“…Understanding longitudinal patterns of tobacco use behaviors is central to curbing tobacco initiation, as this information can identify windows of opportunity in which to intervene to prevent or reduce progression in the severity or intensity of tobacco use [2][3][4][5][6][7] . This is particularly important among never users of a particular TP who may be susceptible to initiation of a particular TP and later on progress to regular TP use.…”