Three Out of 10 Young Adult Tobacco Users Are "Dual Users"

In addition to Cigarettes, Little Cigars and Hookah Popular Among Young Tobacco Users

WASHINGTON, May 23, 2012 /PRNewswire-USNewswire/ -- A new study finds that young adults are not only using cigarettes but also concurrently using more than one tobacco product, including little cigars and hookah. The study, published in the May issue of the Journal of Environmental and Public Health, comes from Legacy®, a national public health organization dedicated to reducing tobacco use in the United States. The research looked at tobacco use patterns among young adults, and included an examination of those using cigarettes plus another tobacco product concurrently (dual use).


According to the data, of the 23 percent of young adults who were current tobacco users, 30 percent reported dual use. "We found that dual users report the same levels of smoking compared to cigarette only users, suggesting that the use of other tobacco products does not replace cigarette smoking or decrease the mean number of cigarettes smoked daily among young adults. This trend toward dual use – especially among young people – is disconcerting," said Jessica Rath, Director of Research and Evaluation for Legacy. "Tobacco companies are pushing new products that leave young adults faced with an array of tobacco products from which to choose. The fact that many are experimenting with these new products, while still smoking cigarettes, may have negative implications for public health," she said.

The researchers used data from the online Legacy Young Adult Cohort Study to describe the prevalence of cigarette, other tobacco product, and dual use in a nationally representative sample of young adults aged 18-34 (n = 4,201). The data show the majority of individuals who use noncigarette (other) tobacco products (64 percent) are smoking cigarettes concurrently. According to the study, those who reported every day or someday use of cigarettes or other tobacco products also identified using the following tobacco products in the past 30 days:

  • Eighty-seven (87 percent) percent had smoked cigarettes; 19 percent currently smoke cigars; and 16 percent currently smoke little cigars/cigarillos/bidis.
  • In addition, 8 percent reported hookah use in the past 30 days.

"This study highlights the need for improved monitoring of tobacco use across the life course. This way, Legacy and other organizations can develop tailored efforts for the young adult population, in order to prevent progression and further reduce overall population prevalence," Rath said.

Much of the focus of tobacco control research and prevention efforts have traditionally centered on teens, given that nearly 80 percent of smokers begin before the age 18. However, there are few data on the prevalence and smoking behavior of young adults in the 18-34 year age group. This study is the first in a series that presents baseline information on this population and is designed to track the patterns, transitions and trajectories of tobacco use behavior in the under-studied age group. Researchers found that 32 percent of young adults (ages 18-34) initiated smoking after age 18 and 39 percent of regular users became regular smokers during young adulthood. In addition, among young adults who currently use tobacco, three in 10 are dual users.

"Earlier this year, the Surgeon General reported that nearly all tobacco use begins during youth, with addiction to nicotine starting right away in youth and young adulthood, while young adults are the prime target for tobacco marketing campaigns," said Cheryl G. Healton, DrPH, Legacy President & and CEO. "Our research shows that young adults are indeed trying smoking and becoming regular smokers," she added.

Legacy – best known for its truth® youth smoking prevention campaign – is committed to reaching young people with the knowledge and facts about tobacco's social and health consequences, so teens can then make informed decisions about smoking. While the campaign is primarily geared towards teens, research has found its hard-hitting messages also resonate with young adults. A December 2010 study in the American Journal of Preventive Medicine found that awareness of the truth campaign reached as high as 68 percent among young adults aged 18 to 24 years.

Description of Little Cigar Products:
Little cigars are almost identical in size and appearance to cigarettes. Unlike cigarettes, which are wrapped in white paper, little cigars are wrapped in paper that contains some tobacco leaf. Cigarillos are longer and slimmer and often rolled in tobacco leaf or papers containing tobacco leaf. Increased use of these products is of particular concern, as users may believe that cigarillos and little cigars are less harmful than cigarettes.

Legacy helps people live longer, healthier lives by building a world where young people reject tobacco and anyone can quit. Legacy's proven-effective and nationally recognized public education programs include truth®, the national youth smoking prevention campaign that has been cited as contributing to significant declines in youth smoking; EX®, an innovative public health program designed to speak to smokers in their own language and change the way they approach quitting; and research initiatives exploring the causes, consequences and approaches to reducing tobacco use. Located in Washington, D.C., the foundation was created as a result of the November 1998 Master Settlement Agreement (MSA) reached between attorneys general from 46 states, five U.S. territories and the tobacco industry. To learn more about Legacy's life-saving programs, visit

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