Sociodemographic Disparities in Nicotine Product Use Patterns in the U.S.: Findings from the 2014/15, 2018/19, and 2022/23 TUS-CPS

Objectives Our study investigated sociodemographic profiles associated with different nicotine use patterns, including exclusive cigarette smoking, exclusive electronic cigarette (EC) use, dual use, and non-use, and identified the factors contributing to the transitions between cigarette smoking and EC use and vice versa, from 2014 to 2023. Study Design This was a repeated cross-sectional study. Methods Data are from Tobacco Use Supplements to Current Population Survey (TUS-CPS) 2014/2015, 2018/2019, and 2022/2023. Chi-squared tests were used to compare sociodemographic profiles across various nicotine product use patterns of exclusive cigarette smoking, exclusive EC use, dual use, and non-use. Multivariate logistic regressions were used to estimate factors associated with completely switching from cigarettes to ECs, and vice versa. Results Findings suggested that a higher proportion of exclusive cigarette smokers were individuals with lower income, lower education, African American, and age groups of 45–54 and 55–64, whereas a higher proportion of exclusive EC users were those with higher income, higher education, White, and younger age groups of 18–24 and 25–34. Furthermore, we found that socioeconomically disadvantaged individuals who had ever used ECs were more likely to completely switch to cigarettes compared to their socioeconomically advantaged counterparts. Conversely, socioeconomically advantaged individuals who had ever used cigarettes were more likely to completely switch to ECs compared to their socioeconomically disadvantaged counterparts. Conclusion Our study identified contrasting sociodemographic patterns and distinct transition pathways between exclusive cigarette smokers and exclusive EC users. These differences suggest that disparities in smoking-attributable morbidity and mortality may continue to widen across socioeconomic subgroups.