Prevalence, harm perceptions, and reasons for using noncombustible tobacco products among current and former smokers

Am J Public Health. 2014 Aug;104(8):1437-44. doi: 10.2105/AJPH.2013.301804. Epub 2014 Jun 12.


Objectives: We provided estimates of noncombustible tobacco product (electronic nicotine delivery systems [ENDS]; snus; chewing tobacco, dip, or snuff; and dissolvables) use among current and former smokers and examined harm perceptions of noncombustible tobacco products and reasons for their use.

Methods: We assessed awareness of, prevalence of, purchase of, harm perceptions of, and reasons for using noncombustible tobacco products among 1487 current and former smokers from 8 US designated market areas. We used adjusted logistic regression to identify correlates of noncombustible tobacco product use.

Results: Of the sample, 96% were aware of at least 1 noncombustible tobacco product, but only 33% had used and 21% had purchased one. Noncombustible tobacco product use was associated with being male, non-Hispanic White, younger, and more nicotine dependent. Respondents used noncombustible tobacco products to cut down or quit cigarettes, but only snus was associated with a higher likelihood of making a quit attempt. Users of noncombustible tobacco products, particularly ENDS, were most likely to endorse the product as less harmful than cigarettes.

Conclusions: Smokers may use noncombustible tobacco products to cut down or quit smoking. However, noncombustible tobacco product use was not associated with a reduction in cigarettes per day or cessation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Racial Groups / statistics & numerical data
  • Sex Factors
  • Smoking Cessation / psychology
  • Tobacco Use / adverse effects
  • Tobacco Use / epidemiology*
  • Tobacco Use / psychology
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / psychology
  • United States / epidemiology
  • Young Adult