The RTI International study found that 14.7 percent of middle and high school students have experimented with more tobacco products, and 4.3 percent of users say that have used more than three products, while 2.7 percent use cigarettes to complement another product.
“The prevalence of teens combining multiple tobacco products is alarming, especially since there may be potential additive harms associated with this practice,” said Youn Ok Lee, Ph.D., research public health analyst at RTI International. “By using more than one tobacco product, teens may be increasing their risk of nicotine dependence.”
The study was published in Pediatrics.
For the study, researchers used data from the 2012 National Youth Tobacco Survey, which is a representative sample of U.S. middle and high school students, to approximate the use of cigarettes, e-cigarettes, cigars, smokeless tobacco, hookah and other tobacco products.
Scientists determined that 4.3 percent of teens accepted the use of three or more tobacco products in the past 30 days, compared to 2.8 percent who use cigarettes exclusively. The percentage is also higher than 2.4 percent of U.S. adults who admitted to using at least three tobacco products reported in other publications.
The findings confirm those in other reports that indicate a decline of cigarette at the expense of other products such as such as e-cigarettes and hookah that are becoming popular among teens.
“Most individuals have their first experience with tobacco during their teen years,” Lee said. “We found that the use of three or more tobacco products was associated with being male, using flavored tobacco products, nicotine dependence, tobacco marketing receptivity and whether the teen thought their peers used tobacco.”
Another finding is that e-cigarettes is twice as high among teens compared to the usage of both e-cigarettes and conventional cigarettes.