ArticleTobacco control2020
Transitions between cigarette, ENDS and dual use in adults in the PATH study (waves 1-4): multistate transition modelling accounting for complex survey design.
Article in Tobacco control, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 76 citations in OpenAlex.
- Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial.JMIR public health and surveillance · 2023Trial
- Product acceptance and cigarette reduction: Results from a Velo® pouch actual use study among United States adults who smoke.Preventive medicine reports · 2026Article
- Longitudinal Transitions Between Internalizing and Externalizing Symptoms and Associations with Substance Use among US Young Adults, 2016-2023.Epidemiology (Cambridge, Mass.) · 2026Article
- Developing Tobacco Risk Communications for Young Adults Susceptible to Dual Use of Combustible Cigarettes and Nicotine Vapes: Mixed Methods Study.JMIR formative research · 2026Article
- Electronic cigarette use, related health outcomes and policy interventions in the USA: a call for research to fill evidence gaps.Tobacco control · 2026Review
- Impact of reducing nicotine in cigarettes on mortality, economic costs and major depression in the USA.Tobacco control · 2026Article
- Continuous associations of the brief Wisconsin Inventory of Smoking Dependence Motives with transitions between cigarette and e-cigarette use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- COPD stage progression and regression: a multistate transition analysis of the COPDGene cohort.American journal of respiratory and critical care medicine · 2026Article
- Transitions in ENDS and cigarette use among youth in the PATH Study from 2015-2023: a multistate transition modeling analysis.medRxiv : the preprint server for health sciences · 2026Article
- Identifying Latent Classes of Dual Cigarette/ENDS Users Based on Motivations for ENDS Use: Product Substitution Versus Complementary Use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Urinary Tobacco and Nicotine Exposure Biomarkers as Predictors of Transitions between Cigarette and e-Cigarette Use in the Exhale Longitudinal Cohort Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Observational
- E-cigarette Duration and Incident COPD Among Adults Aged 40 Years and Older with a Smoking History.medRxiv : the preprint server for health sciences · 2026Article
- Transitions in cigarette and ENDS use in the PATH Study: a multistate transition model analysis of adults in 2021-2022 compared to previous years.medRxiv : the preprint server for health sciences · 2025Article
- Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021.Tobacco control · 2025Article
- Transitions and patterns in concurrent use of cigarettes and electronic cigarettes: An intensive longitudinal study of adults who smoke cigarettes and recently initiated e-cigarette use.Addictive behaviors · 2025Article
- Projected Impact of Higher E-cigarette or Combustible Cigarette Taxes on Use of Both Products in the U.S.AJPM focus · 2025Article
- Predictors of transitions between normal cognition, cognitive impairment, and dementia in a longitudinal cohort.Journal of Alzheimer's disease : JAD · 2025Article
- Theory-based strategies to enhance interventions for smoking: Relevance to a digital intervention.Behaviour research and therapy · 2025Review
- The association of modifiable and socio-demographic factors with first transitions from smoking to exclusive e-cigarette use, dual use or no nicotine use: Findings from the Avon Longitudinal Study of Parents and Children United Kingdom birth cohort.Addiction (Abingdon, England) · 2025Article
- Patterns of heated tobacco product use and biochemically verified smoking status among customers of dedicated heated tobacco product stores.Internal and emergency medicine · 2025Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
introductionEven prior to 2018, electronic nicotine delivery systems (ENDS) began to dramatically change the landscape of tobacco products and product use patterns in the USA.
methodsUsing a Markov multistate transition model accounting for complex survey design, transition rates between never, non-current, cigarette, ENDS and dual use states were estimated for 23 253 adult participants in waves 1-4 (approximately 2013-2017) of the Population Assessment of Tobacco and Health study. We made short-term transition projections and estimated HRs for age, sex, race/ethnicity, education and income.
resultsCigarette use was persistent among adults, with 89.7% (95% CI 89.1% to 90.3%) of exclusive cigarette users and 86.1% (95% CI 84.4% to 87.9%) of dual users remaining cigarette users (either exclusive or dual) after one wave. In contrast, ENDS use was less persistent, with 72.1% (95% CI 69.6% to 74.6%) of exclusive ENDS users and 50.5% (95% CI 47.8% to 53.3%) of dual users remaining ENDS users (with or without cigarettes) after one wave. Exclusive ENDS users were more likely to start cigarette use after one wave than either never users (HR 25.2; 95% CI 20.9 to 30.5) or non-current users (HR 5.0; 95% CI 4.3 to 5.8). Dual users of ENDS and cigarettes were more likely to stop using cigarettes than exclusive cigarette users (HR 1.9; 95% CI 1.6 to 2.3). Transition rates varied among sociodemographic groups.
conclusionsMultistate transition models are an effective tool for uncovering and characterising longitudinal patterns and determinants of tobacco use from complex survey data. ENDS use among US adults was less persistent than cigarette use prior to 2018.
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