Influence of Tobacco Use Patterns on Smoking Cessation Success in Adults Who Smoke Cigarettes in the U.S.

Introduction: This study aimed to assess the association between tobacco use patterns and cigarette smoking cessation in a representative cohort of adults who smoked combustible cigarettes in the U.S. Methods: Study included current cigarette smoking adults in Wave 4 of the Population Assessment of Health and Tobacco study (N=5,669). Patterns of use were exclusive cigarette smoking, dual cigar and cigarette smoking, dual ENDS use, and multiple product use (poly use). Abstinence status (cessation) was obtained from Population Assessment of Health and Tobacco study Wave 5 and defined as abstinent ≥3 months. Weighted multivariable logistic regression analyses were performed. Analyses were completed in June 2024. Results: Exclusive cigarette smoking was 82.0%, and dual cigar smoking and dual ENDS use constituted 3.7% and 4.4%, respectively. Of adults who smoked cigarettes, 25.7% were abstinent ≥3 months at follow-up. Adults with dual cigar smoking (20.8%) were more likely to be abstinent ≥3 months than those who smoked cigarettes exclusively (10.0%). Adults reporting dual cigar smoking had higher odds of being 3-month abstinent than those reporting exclusive cigarette smoking (OR=2.60, 95% CI=1.60, 4.21). Conclusions: Dual cigar smoking is positively associated with smoking abstinence in adults 1 year later. A deeper understanding of the dynamics and characteristics of dual cigar smoking that rendered cigarette smoking cessation more likely is needed. The data did not offer supporting evidence for dual ENDS use as a cessation aid. The majority of smoking cessation was achieved without the use of assistance.