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Published in Addictive Behaviors 32 (2007) 2411–2419.


Background: The primary focus of tobacco prevention and cessation interventions has been on cigarette smoking. Polytobacco use (the concurrent use of cigarettes and one or more other tobacco product[s]), may present additional health risks and make cessation more difficult.
Methods: We determined population estimates of tobacco product use and of polytobacco use for more than 50000 adults from 10 states. Logistic regression analyses were used to determine factors independently associated with polytobacco use among men only (due to low use among women).
Results: The overall adult prevalence was 22.4% for cigarettes and 3.4% for polytobacco use. Polytobacco use was more common among men who smoked cigarettes, with 26.0% using at least one other product, compared to 4.4% of women cigarette smokers. Polytobacco use among men was significantly associated with younger age, all races/ ethnicities except Hispanic, less educational attainment, less income, and more-than-moderate alcohol use.
Conclusions: Prevention and cessation efforts need to target use of other forms of tobacco besides cigarettes, especially among younger men and men who are more-than-moderate drinkers of alcohol.

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