Adult dual and polytobacco use in the United States: Findings from the 2021-2023 National Survey on Drug Use and Health.

OBJECTIVES

Multiple tobacco product (MTP) use is common among tobacco users. Current, detailed estimates of MTP use patterns among users of different tobacco products can inform tobacco treatment and regulation.

METHODS

Data were pooled from 2021 to 2023 National Survey on Drug Use and Health (United States) adult respondents. We derived estimates of past-month MTP use, mutually exclusive use patterns, and correlates of MTP use among current tobacco users, and stratified by tobacco product used and age.

RESULTS

MTP use was reported by 23.7 % of tobacco users; it was most prevalent among ages 18-25 (34.6 %) and 26-34 (31.0 %). Past-month dual cigarette/e-cigarette use was the most prevalent MTP use pattern (39.6 % of MTP users). Binge drinking, major depressive episode, and illicit drug use were associated with greater odds of MTP use. Older age was associated with lower odds of MTP use, except among ENDS users, where odds of MTP use decreased with older age.

CONCLUSIONS

MTP use is prevalent among adult tobacco users. We report current, comprehensive estimates of MTP use and associated correlates. MTP use and product use patterns varied by age among users of different products. Findings have implications for clinicians, tobacco treatment specialists, and regulators.