Cigarette Smoking Remains A Huge Public Health Problem Interview with:
Andrew Hyland, PhD

Chair of the Department of Health Behavior at Roswell Park Cancer Institute and
Karin Kasza, MA
Senior Research Specialist in the Department of Health Behavior
Roswell Park Cancer Institute What is the background for this study? What are the main findings?

Response: The PATH Study is unique because it is a large, nationally representative study of more than 45,000 youth and adults who are interviewed at multiple points over time and asked about their use of a wide array of tobacco products. The data reported in this study are from the baseline wave, and we find that while cigarettes are by far the most commonly used product for both youth and adults, we see a lot of use of non-cigarette products. E-cigarettes trailed only cigarettes in popularity for youth and water pipe smoking was high among 18-24 year olds. However, we see different patterns of use for different products with cigarettes being used much more frequently that other products like e-cigarettes. Another surprising finding was that about 4 in 10 youth and adult tobacco users were currently using two or more tobacco products. What should readers take away from your report?

Response: The more things change the more things stay the same. There are new products and we see a lot of experimentation with different tobacco products, which we need to continue to track and understand what factors are driving those tobacco use patterns. However, cigarettes are incredibly lethal and we continue to see cigarette use as the predominant form of tobacco for both youth and adults. Cigarette smoking remains a huge public health problem and reducing cigarette smoking is the biggest opportunity to improve public health. What recommendations do you have for future research as a result of this study?

Response: The data from the baseline wave of the PATH Study provide two big opportunities for future research. The first opportunity is to understand how tobacco use behaviors change within individuals over time and what factors are responsible for those changes. For example, we see a lot of people using two or more tobacco products at the same time. By looking at additional waves of data collection we will be able to better understand if this is a transient step that leads people to less tobacco use or a step toward greater nicotine addiction.

The second opportunity for future research is to examine how different tobacco use patterns are related to indicators of health. Additional future data from the PATH Study will allow us to see if use of products like e-cigarettes or smokeless tobacco is associated with changes in harmful exposures and ultimately health outcomes. Is there anything else you would like to add?

Response:  Author disclosure forms are available with the full text of the article at Thank you for your contribution to the community.


Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014
Karin A. Kasza, M.A., Bridget K. Ambrose, Ph.D., Kevin P. Conway, Ph.D., Nicolette Borek, Ph.D., Kristie Taylor, Ph.D., Maciej L. Goniewicz, Pharm.D., Ph.D., K. Michael Cummings, Ph.D., M.P.H., Eva Sharma, Ph.D., Jennifer L. Pearson, Ph.D., M.P.H., Victoria R. Green, B.A., Annette R. Kaufman, Ph.D., M.P.H., Maansi Bansal-Travers, Ph.D., Mark J. Travers, Ph.D., Jonathan Kwan, M.S., Cindy Tworek, Ph.D., M.P.H., Yu-Ching Cheng, Ph.D., Ling Yang, M.D., Ph.D., Nikolas Pharris-Ciurej, Ph.D., Dana M. van Bemmel, Ph.D., M.P.H., Cathy L. Backinger, Ph.D., M.P.H., Wilson M. Compton, M.D., M.P.E., and Andrew J. Hyland, Ph.D.
N Engl J Med 2017; 376:342-353January 26, 2017DOI: 10.1056/NEJMsa1607538

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on January 27, 2017 by Marie Benz MD FAAD