ArticleTobacco control2025
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.
Article in Tobacco control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Impact of reducing nicotine in cigarettes on mortality, economic costs and major depression in the USA.Tobacco control · 2026Article
- Trends in adult exclusive and dual use of combustible and non-combustible tobacco products in the United States.JNCI cancer spectrum · 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
- Joinpoint trend analysis of prevalence of combustible and non-combustible tobacco product use by adults in the United States, using cross-sectional data from NHIS 2015-2023.Tobacco induced diseases · 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
- Health, Equity, and Economic Impacts of a Nicotine Product Standard in the United States for People With and Without Major Depression.medRxiv : the preprint server for health sciences · 2025Article
- Scoping of Policy Impacts for Regulating E-cigarettes (SPIRE): findings from a data and decision analytic model mapping project.NIHR open research · 2025Article
- Coupons and state tobacco policy context as predictors of tobacco use among those reporting e-cigarette use in the U.S.: Findings from the Population Assessment of Tobacco and Health (PATH) Study waves 5-6 (2018-2021).Preventive medicine reports · 2025Article
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Abstract
introductionThe use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the lung injuries outbreak, flavour bans, Tobacco 21 and the COVID-19 pandemic.
methodsUsing the Population Assessment of Tobacco and Health Study, we applied a multistate transition model to 28 061 adults in waves 4-5 (2017-2019) and 24 584 adults in waves 5-6 (2019-2021), estimating transition rates for initiation, cessation and switching products for each period overall and by age group.
resultsCigarette initiation among adults who never used either product decreased from 2017-2019 to 2019-2021, but ENDS initiation did not significantly change. The persistence of ENDS-only use remained high (75%-80% after 1 year). Cigarette-only use transitions remained similar (88% remaining, 7% to non-current use and 5% to dual or ENDS-only use). In contrast, dual use to ENDS-only transitions increased from 9.5% (95% CI 7.3% to 11.7%) to 20.0% (95% CI 17.4% to 22.6%) per year, decreasing the persistence of dual use. The dual to cigarette-only use transition remained at about 25%. These changes were qualitatively similar across adult age groups, though adults ages 18-24 years exhibited the highest probability of switching from cigarette-only use to dual use and from dual use to ENDS-only use.
conclusionsThe persistence of ENDS use among adults remained high in 2019-2021, but a larger fraction of dual users transitioned to ENDS-only use compared with 2017-2019. Because the fraction of cigarette-only users switching to dual use remained low, especially among older adults, the public health implications of this change are minimal.
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