Introduction: Although use of non-cigarette alternative tobacco products (ATPs) is increasingly prevalent in the United States, little is known about the varying patterns of tobacco use among college students. This study examined prevalence of ATP use and differences across 4 groups of students (nontobacco, cigarette-only, polytobacco, and ATP-only users) on perceptions of danger and beliefs about government safety evaluation of tobacco products.
Methods: An online survey was administered to 5,028 students attending 7 public universities within a larger university system (M age = 20.5 years, 59.6% female, 54.6% Hispanic/Latino). Multivariate analyses were conducted to investigate differences between the 4 groups on perceived danger of tobacco products and beliefs regarding government safety evaluation of these products.
Results: Prevalence of ATP use among the sample ranged from 0.4% for dissolvable tobacco to 10.8% for hookah. Group membership was significantly associated with perceived danger of each tobacco product, whereby cigarette-only and ATP-only users reported significantly higher levels of perceived danger for most ATPs than did polytobacco users. Furthermore, cigarette-only, polytobacco, and ATP-only users were significantly more likely than nonusers to believe that the government evaluates some tobacco products for safety.
Conclusions: ATP use among young adult college students is prevalent. Furthermore, students who use ATPs in conjunction with cigarettes (i.e., polytobacco users) appear to be at highest risk for the continuation and subsequent dependence on nicotine, given their danger perceptions and beliefs of government evaluation. Future research examining trajectories of use, particularly among polytobacco users, is needed.