. 2019 Oct 23;2(10):e1913804. doi: 10.1001/jamanetworkopen.2019.13804

Table 1. Association Between First Tobacco Product Flavored Among Youth Ever Tobacco Users at Wave 1 and Product-Specific Tobacco Use at Wave 2 of the Population Assessment of Tobacco and Health Study.

Ever Tobacco Use at Wave 1	Past 12-mo Use at Wave 2^a		Past 30-d Use at Wave 2^b		≥6 d Use at Wave 2^c		≥20 d Use at Wave 2^c		Daily Product Use at Wave 2^c
Ever Tobacco Use at Wave 1	Participants, No. (%)	aPR (95% CI)^d	Participants, No. (%)	aPR (95% CI)^d	Participants, No. (%)	aPR (95% CI)^d	Participants, No. (%)	aPR (95% CI)^d	Participants, No. (%)	aPR (95% CI)^d
Ever cigarette use
First product nonflavored	453 (60)	1 [Reference]	293 (39)	1 [Reference]	178 (23.9)	1 [Reference]	130 (17.2)	1 [Reference]	99 (12.8)	1 [Reference]
First product flavored	531 (68.3)	1.14 (1.05-1.25)	342 (44.94)	1.15 (1.00-1.31)	193 (24.9)	1.05 (0.85-1.29)	142 (17.8)	1.11 (0.85-1.47)	107 (13.4)	1.21 (0.92-1.59)
First product menthol or mint flavored^e	470 (69.9)	1.18 (1.08-1.29)	309 (46.8)	1.19 (1.04-1.37)	174 (25.9)	1.09 (0.88-1.34)	129 (18.6)	1.17 (0.88-1.56)	99 (14.2)	1.30 (0.97-1.72)
Ever e-cigarette use
First product nonflavored	122 (52.5)	1 [Reference]	58 (23.3)	1 [Reference]	22 (9)	1 [Reference]	NA^f	1 [Reference]	NA^f	1 [Reference]
First product flavored	569 (58.9)	1.12 (0.96-1.29)	266 (28.4)	1.19 (0.91-1.55)	105 (11.8)	1.39 (0.82-2.36)	55 (6.2)	1.67 (0.77-3.63)	42 (4.5)	2.29 (0.81-6.50)
Ever any cigar use
First product nonflavored	182 (64.9)	1 [Reference]	97 (36.3)	1 [Reference]	NA^f	1 [Reference]	NA^f	1 [Reference]	NA^f	NA^f
First product flavored	398 (69.8)	1.08 (0.96-1.21)	182 (33.7)	0.94 (0.72-1.21)	35 (6.5)	NA^g	18 (3.4)	NA^g	NA^f	NA^f
Ever use of traditional cigar
First product nonflavored	85 (65)	1 [Reference]	41 (31.3)	1 [Reference]	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
First product flavored	88 (69.4)	1.16 (0.98-1.37)	34 (27.6)	0.92 (0.57-1.49)	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
Ever use of cigarillos
First product nonflavored	160 (64.3)	1 [Reference]	83 (34.8)	1 [Reference]	NA^f	1 [Reference]	NA^f	NA^f	NA^f	NA^f
First product flavored	307 (63.4)	1.00 (0.87-1.15)	128 (27.7)	0.81 (0.61-1.07)	17 (3.7)	NA^g	NA^f	NA^f	NA^f	NA^f
Ever use of filtered cigars
First product nonflavored	51 (57.3)	1 [Reference]	13 (14.4)	1 [Reference]	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
First product flavored	118 (65)	1.10 (0.84-1.44)	29 (14.8)	0.95 (0.39-2.34)	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
Ever use of pipe tobacco
First product nonflavored	53 (35.9)	1 [Reference]	17 (11.9)	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
First product flavored	21 (31.2)	0.77 (0.41-1.46)	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
Ever use of hookah tobacco
First product nonflavored	56 (56)	1 [Reference]	23 (24.8)	1 [Reference]	NA^f	1 [Reference]	NA^f	1 [Reference]	NA^f	NA^f
First product flavored	480 (64)	1.09 (0.87-1.37)	183 (24.5)	0.91 (0.55-1.51)	38 (4.8)	0.62 (0.23-1.67)	19 (2.5)	0.62 (0.16-2.46)	NA^f	NA^f
Ever use of any smokeless tobacco^h
First product nonflavored	51 (41.6)	1 [Reference]	24 (19.5)	1 [Reference]	13 (11)	1 [Reference]	NA^f	1 [Reference]	NA^f	1 [Reference]
First product flavored	216 (54.5)	1.29 (0.99-1.68)	132 (33.9)	1.76 (1.21-2.57)	77 (20.2)	1.77 (0.92-3.40)	65 (17.1)	1.94 (0.92-4.12)	49 (12.5)	NA^g
Ever use of smokeless tobacco (excluding snus)
First product nonflavored	65 (48.1)	1 [Reference]	34 (25.1)	1 [Reference]	23 (17.7)	1 [Reference]	21 (16.3)	1 [Reference]	18 (14)	1 [Reference]
First product flavored	169 (51.3)	1.12 (0.88-1.41)	106 (32.6)	1.32 (0.98-1.79)	63 (19.7)	1.05 (0.67-1.65)	54 (16.6)	0.98 (0.61-1.59)	40 (12.2)	NA^g
Ever use of snus
First product nonflavored	NA^f	1 [Reference]	NA^f	1 [Reference]	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
First product flavored	80 (50.1)	1.37 (0.67-2.80)	32 (19.7)	1.22 (0.26-5.60)	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
Ever use of dissolvable tobacco
First product nonflavored	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f
First product flavored	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f	NA^f

Abbreviations: aPR, adjusted prevalence ratio; NA, not applicable.

^{^a}

Past 12-month use was defined as smoked or used product (even 1 or 2 times) in the past 12 months. Individuals who responded “don’t know” or refused to answer were excluded from the denominator. Unweighted numbers (percentages) of respondents excluded from the denominator for past 12-month use were as follows: cigarettes, 0 (0.0%); e-cigarettes, 26 (2.1%); any cigar, 2 (0.2%); traditional cigars, 1 (0.4%); cigarillos, 2 (0.3%); filtered cigars, 1 (0.4%); pipe, 2 (0.9%); hookah, 1 (0.1%); any smokeless product, 6 (1.1%); smokeless product, 4 (0.8%); and snus, 2 (1.0%).

^{^b}

Past 30-day use was defined as smoked or used product (even 1 or 2 times) in the past 30 days. Individuals who responded “don’t know” or refused to answer were excluded from the denominator. Unweighted numbers (percentages) of respondents excluded from the denominator for past 30-day use were as follows: cigarettes, 3 (0.2%); e-cigarettes, 27 (2.2%); any cigar, 34 (3.9%); traditional cigars, 2 (0.8%); cigarillos, 31 (4.2%); filtered cigars, 1 (0.4%); pipe, 2 (0.9%); hookah, 4 (0.5%); any smokeless product, 8 (1.5%); smokeless product, 5 (1.0%); and snus, 1 (0.5%).

^{^c}

Moderate use was defined as having smoked or used the product on at least 6 of the past 30 days. Frequent product use was defined as having smoked or used the product on at least 20 of the past 30 days. Daily use among youth was defined as having smoked or used the product on 30 of the past 30 days. Individuals who responded “don’t know” or refused to answer were excluded from the denominator. Unweighted numbers (percentages) of respondents excluded from the denominator for moderate, frequent, and daily use were as follows: cigarettes moderate or frequent use, 25 (1.6%); cigarettes daily use, 12 (0.8%); e-cigarettes moderate or frequent use, 60 (4.9%); e-cigarettes daily use, 34 (2.8%); any cigar product moderate use, 54 (6.3%); any cigar product frequent use, 57 (6.7%); cigarillos moderate use, 29 (3.9%); hookah moderate or frequent use, 11 (1.3%); any smokeless tobacco product moderate use, 18 (3.4%); any smokeless tobacco product frequent use, 19 (3.5%); any smokeless tobacco product daily use, 10 (1.9%); smokeless tobacco moderate or frequent use, 11 (2.3%); and smokeless tobacco daily use, 7 (1.5%).

^{^d}

Multivariable modified Poisson regression models among youth were adjusted for sex, race/ethnicity, education, past 30-day alcohol, marijuana, or other drug use, and 3 Global Appraisal of Individual Needs–Short Screener subscales (internalizing problems, externalizing problems, and substance use problems). Individuals who reported “don’t know” or refused to answer any of these items were treated as missing. Among youth ever tobacco users, data were missing for sex (0 participants [0.0%]), race/ethnicity (0 participants [0.0%]), education (128 participants [5.2%]), past 30-day alcohol, marijuana, or other drug use (64 participants [2.6%]), internalizing problems subscale (52 participants [2.1%]), externalizing problems subscale (93 participants [3.8%]), and substance use problems subscale (91 participants [3.7%]). Respondents who reported never alcohol, marijuana, or other drug use were categorized as non–past 30-day users.

^{^e}

A separate comparison was made between wave 1 cigarette smokers who first smoked a menthol or mint flavored cigarette vs smokers who first smoked a nonflavored cigarette. Individuals who reported first other flavored cigarette use were excluded from the denominator.

^{^f}

The estimate was suppressed because it has low statistical precision. It is based on a sample size of less than 50, or the coefficient of variation of the estimate is larger than 30%.

^{^g}

There were insufficient observations to compute balanced repeated replication SEs.

^{^h}

Any smokeless tobacco use was defined as smokeless and/or snus use.