{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:32:18Z","timestamp":1793305938753,"version":"4.5.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T00:00:00Z","timestamp":1690329600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Cancer Institute of the National Institute of Health","award":["U54-CA229974"],"award-info":[{"award-number":["U54-CA229974"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine trends in single, dual, and polytobacco use between 2014-2020 for US youth and to identify disparities in these trends by grade level, sex, and race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A secondary analysis of the National Youth Tobacco Survey (NYTS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>A total of 122\u00a0566 students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Past 30-day exclusive use of cigarettes, e-cigarettes, other combustibles (cigars, little cigars, cigarillos, hookah, pipe tobacco, bidis) and smokeless tobacco (snus, smokeless, dissolvable); dual use of each product with e-cigarettes; polyuse with e-cigarettes; dual\/polyuse without e-cigarettes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>Multivariable modified Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to 2014, exclusive e-cigarette use (APR = 2.51, 95% CI: 1.96, 3.21) trended upward while exclusive cigarette (APR = .34, 95% CI: .23, .50), \u2018other\u2019 combustibles (APR = .47, 95% CI: .37, .58), and smokeless tobacco (APR = .40, 95% CI: .25, .65) use trended downward in 2020. Polytobacco use with and without e-cigarettes trended downward in 2020 compared to 2014. We also saw differences in trends across sociodemographic groups. Comparing 2020 to 2014, exclusive e-cigarette use was higher for females than males, \u2018other\u2019 combustible tobacco use remained stable for Non-Hispanic Black students but decreased for other racial\/ethnic groups, and dual e-cigarette\/cigarette use trended upward more for middle school students than high school students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite decreased trends in tobacco product use without e-cigarettes between 2014-2020, differences in tobacco product use trends by grade level, sex, and race\/ethnicity were identified. Prevention efforts targeting disparities in tobacco product use are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171231191557","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T22:14:06Z","timestamp":1690409646000},"page":"1078-1090","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Trends of Single, Dual, and Polytobacco Use Among School-Based Students in the United States: An Analysis of the National Youth Tobacco Survey"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6363-2940","authenticated-orcid":false,"given":"Steven","family":"Cook","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephany","family":"Ortiz Chavez","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6982-388X","authenticated-orcid":false,"given":"Luis","family":"Zavala-Arciniega","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6532-1372","authenticated-orcid":false,"given":"Jana L.","family":"Hirschtick","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy L.","family":"Fleischer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,26]]},"reference":[{"key":"bibr1-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.27465"},{"issue":"1","key":"bibr2-08901171231191557","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-10013-y","volume":"21","author":"O\u2019Brien D","year":"2021","journal-title":"BMC Publ Health"},{"key":"bibr3-08901171231191557","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6806e1"},{"key":"bibr4-08901171231191557","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6950a1"},{"key":"bibr5-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.18387"},{"key":"bibr6-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1007\/s00038-018-1166-7"},{"key":"bibr7-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2018.04.010"},{"key":"bibr8-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1177\/0890117117743361"},{"key":"bibr9-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2019.04.009"},{"key":"bibr10-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntw028"},{"key":"bibr11-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2020.11.019"},{"key":"bibr12-08901171231191557","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15040699"},{"key":"bibr13-08901171231191557","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18157781"},{"key":"bibr14-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109272"},{"key":"bibr15-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177073"},{"key":"bibr16-08901171231191557","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19052965"},{"key":"bibr17-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1177\/0890117120964065"},{"key":"bibr18-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntaa037"},{"key":"bibr19-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.02.024"},{"key":"bibr20-08901171231191557","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6812a1"},{"key":"bibr21-08901171231191557","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2019.01.031"},{"key":"bibr22-08901171231191557","unstructured":"Services UDoHaH. 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