{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:01:03Z","timestamp":1784660463560,"version":"3.55.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adolescent nicotine use in the United States has diversified over the past two decades, with the rise of electronic nicotine delivery systems and oral nicotine products (ONPs) such as pouches, lozenges, candies, and gum. Declining vaping rates alongside growing ONP use signal shifting consumption patterns and necessitate an updated profile of the modern adolescent polynicotine user.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data came from the 2023 National Youth Tobacco Survey (n\u2009=\u20098585 high school students). Latent class analysis identified subgroups based on patterns of nicotine product use. Multivariable analyses examined associations between class membership and socioenvironmental and individual-level factors, including neighborhood disorder, school-level nicotine visibility, household tobacco exposure, social media use, mental health, and executive functioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four distinct classes emerged: abstainers, dual users (combustible and electronic cigarettes), generalists (multi-modal users), and vape-focused youth. Generalists represented a small but high-risk subgroup characterized by multiple forms of use, higher exposure to neighborhood disorder, permissive school norms, and tobacco use within the home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings highlight the growing complexity of adolescent nicotine use and the need for ecological approaches that consider contextual and behavioral influences. Continued surveillance and targeted interventions are essential to address multi-modal use and anticipate emerging trends in youth nicotine consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>These findings underscore the evolving nature of adolescent nicotine use and the emergence of complex, multi-product use patterns that extend beyond vaping. The identification of a \u201cgeneralist\u201d subgroup, characterized by extensive product engagement and heightened contextual risk, suggests that prevention and intervention strategies must address not only individual behaviors but also social and environmental influences. Incorporating ecological frameworks into youth nicotine research and policy could improve surveillance sensitivity, guide targeted messaging, and enhance prevention efficacy as the landscape of nicotine product development and marking continues to evolve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag150","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:57:43Z","timestamp":1783573063000},"source":"Crossref","is-referenced-by-count":0,"title":["Evolving patterns of adolescent nicotine use in the United States: an ecological perspective"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6982-5428","authenticated-orcid":false,"given":"Adam M","family":"Lippert","sequence":"first","affiliation":[{"name":"Department of Sociology, University of Colorado , 1380 Lawrence Street, Suite 420, Denver, CO 80204 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"2026072114020032500_ref1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.31486\/toj.23.0113","article-title":"Trends in cigarette smoking among United States adolescents","volume":"23","author":"Mejia","year":"2023","journal-title":"Ochsner J"},{"key":"2026072114020032500_ref2","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.15585\/mmwr.mm6950a1","article-title":"Tobacco product use among middle and high school students \u2014 United States, 2020","volume":"69","author":"Gentzke","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026072114020032500_ref3","doi-asserted-by":"crossref","first-page":"774","DOI":"10.15585\/mmwr.mm7335a3","article-title":"E-cigarette and nicotine pouch use among middle and high school students \u2014 United States, 2024","volume":"73","author":"Park-Lee","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026072114020032500_ref4","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.jadohealth.2023.02.040","article-title":"Pandemic-related changes in the prevalence of early adolescent alcohol and drug use, 2020-2021: data from a multisite cohort study","volume":"73","author":"Pelham","year":"2023","journal-title":"J Adolesc Health"},{"key":"2026072114020032500_ref5","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2024-067767","article-title":"E-cigarette use by female vs male high school students","volume":"154","author":"Seidenberg","year":"2024","journal-title":"Pediatrics."},{"key":"2026072114020032500_ref6","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1136\/tobaccocontrol-2021-056720","article-title":"Youth-appealing features in popular e-cigarette brand advertising in the USA after heightened scrutiny in 2018","volume":"32","author":"Liu","year":"2023","journal-title":"Tob Control"},{"key":"2026072114020032500_ref7","first-page":"2024","volume-title":"Tobacco Product Use among Middle and High School Students \u2014 National Youth Tobacco Survey, United States, 2024","author":"Ahmed","year":"2024"},{"key":"2026072114020032500_ref8","doi-asserted-by":"crossref","first-page":"tc-2024-059010","DOI":"10.1136\/tc-2024-059010","article-title":"Content analysis of marketing features in US nicotine pouch ads from 2021 to 2023","author":"Czaplicki","year":"2024","journal-title":"Tob Control"},{"key":"2026072114020032500_ref9","doi-asserted-by":"crossref","first-page":"108211","DOI":"10.1016\/j.addbeh.2024.108211","article-title":"Mobile phone ownership, social media use, and substance use at ages 11-13 in the ABCD study","volume":"161","author":"Doran","year":"2025","journal-title":"Addict Behav"},{"key":"2026072114020032500_ref10","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/ntr\/ntae081","article-title":"#Discreetshipping: selling E-cigarettes on TikTok","volume":"27","author":"Dobbs","year":"2025","journal-title":"Nicotine Tob Res"},{"key":"2026072114020032500_ref11","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.15585\/mmwr.mm7244a1","article-title":"Tobacco product use among US middle and high school students - 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