More than a quarter of U.S. adults use tobacco

More than one in four adults and nearly one in 10 youth use tobacco, according to findings from the Population Assessment of Tobacco and Health (PATH) Study, published online ahead of print in the New England Journal of Medicine.

The PATH Study, established in 2011 through collaboration between the National Institutes of Health’s National Institute on Drug Abuse and the U.S. Food and Drug Administration’s Center for Tobacco Products, is a uniquely large, nationally representative longitudinal study designed to examine tobacco use behaviors and health among the U.S. population over multiple years of follow-up. The PATH Study is being conducted by Westat of Rockville, Mariland, with Roswell Park Cancer Institute as the scientific lead.

“Tobacco use continues to be an overwhelming economic and personal burden in this country. This research provides a unique and much-needed long-term approach to understanding tobacco use and the impact those behaviors have on individuals and on society as a whole,” says Andrew Hyland, chair of the Department of Health Behavior at Roswell Park Cancer Institute and principal investigator of the PATH Study.

The present study reports findings from the baseline wave of data collection, conducted from September 2013 to December 2014. As part of that first wave of the PATH Study data collection, 32,320 adults and 13,651 youths (ages 12-17) were asked about their use of 12 types of tobacco products, including cigarettes, e-cigarettes, cigars, pipe tobacco, hookah, smokeless tobacco and snus.

The research team found that 27.6 percent of American adults are current tobacco users and 8.9 percent of youth reported using tobacco in the previous 30 days. Use of multiple tobacco products was common among both adult and youth users, with cigarettes and e-cigarettes being the most common combination.

“These findings will serve as the baseline for comparison to future waves of PATH Study data in our effort to understand changes in use of tobacco products over time, including switching among types of products, quitting tobacco, and trajectories of use of multiple products,” says Karin Kasza, MA, senior research specialist in the Department of Health Behavior at Roswell Park and lead author of the study published today.

“The study documents that tobacco use is about much more than just cigarettes,” adds study co-author Wilson M. Compton, deputy director of the National Institute on Drug Abuse. “Both youth and adults use a remarkably broad variety of tobacco products.”

“The findings from the PATH Study will help inform the FDA’s efforts to regulate tobacco products in such a way that reduces harm and protects public health. We look forward to findings from future study waves that will help us better understand patterns of tobacco use in the U.S. and, ultimately, how such behaviors influence health,” says David L. Ashley, director of the Center for Tobacco Products’ Office of Science.

Additional PATH Study partners are the Truth Initiative, the University of California at San Diego, University of Waterloo, Geisel School of Medicine at Dartmouth, Medical University of South Carolina, Rutgers University and University of Minnesota.

This manuscript is supported with federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Food and Drug Administration, Department of Health and Human Services, under a contract to Westat (Contract No. HHSN271201100027C). The study, “Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014,” is available at