Sociodemographic differences in single, dual, and poly tobacco use among Appalachian youth

Delvon T. Mattingly, Joy L. Hart, Lindsey A. Wood, Kandi L. Walker

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


INTRODUCTION Patterns of youth tobacco use, including use of multiple products, have likely shifted as e-cigarettes have grown in popularity. However, there is limited understanding of dual and poly tobacco use and the associated disparities, especially among Appalachian youth. METHODS We analyzed Youth Appalachian Tobacco Study data (n=1116) to estimate prevalence of current (past-30 day) cigarette, e-cigarette, and smokeless tobacco use by gender, race/ethnicity, age, school type, state, smartphone use, and number of household tobacco users. We created a pattern of tobacco use variable (i.e. never, former, single, dual, poly) based on all possible combinations of the included products. Using multivariable multinomial logistic regression (outcome reference: never use), we evaluated associations between sociodemographic characteristics and patterns of tobacco use. RESULTS Former (16.2%) was the most common tobacco use group, followed by single (10.8%), dual (4.5%), and poly (2.4%) use. Dual and poly use were more prevalent among males, Whites/Caucasians, older participants, and participants living in households with tobacco users. Kentucky residents (vs New York) had higher odds of dual use (OR=5.15; 95% CI: 1.72–15.44), and youth who used smartphones for ≥20 hours/week (vs <20 hours/week) had greater odds of poly use (OR=3.02; 95% CI: 1.34–6.80). CONCLUSIONS Differences in single, dual, and poly tobacco use were evidenced by sociodemographic characteristics. Additional inquiry should further examine these disparities so that tobacco prevention interventions can be appropriately tailored.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalTobacco Prevention and Cessation
StatePublished - Jul 2020

Bibliographical note

Publisher Copyright:
© 2020 Mattingly D. T. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 International License.


  • Appalachia
  • dual tobacco use
  • electronic cigarettes
  • poly tobacco use
  • tobacco
  • youth

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Health Professions (miscellaneous)
  • Public Health, Environmental and Occupational Health


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