Trends in transitions in cigarette and electronic nicotine vapor product use in the Rutgers Omnibus Study, 2022–2026
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Introduction
Monitoring transitions in cigarette and electronic nicotine vapor product (ENVP) use is important for understanding how marketplace and regulatory changes have affected product use patterns, but information from national surveys is often delayed by several years.
Methods
The Rutgers Omnibus Study is a quarterly serial, rapid-response, web-based convenience survey. Using a Markov multistate transition model, we estimated transition rates and one-year transition probabilities between never, non-current, ENVP-only, cigarette-only, and dual use among 5,292 adults aged 18–45 who participated in at least two of Waves 1–16 (February 2022–February 2026), as well as overall transition hazard ratios by sex, age group, and race & ethnicity in a multivariable model.
Results
About 40% of individuals using cigarettes (39.5%; 95% CI: 36.9–42.0) or ENVP (40.1%; 95% CI: 36.4–43.7), and 60% of those using both products (60.8%; 95% CI: 58.3–63.2) were predicted to remain in those states after one year. Female participants began using cigarettes from never use (adjusted hazard ratio [aHR] 0.44; 95% CI: 0.29–0.66) or non-current use (aHR 0.65; 95% CI: 0.48–0.88) at lower rates than male participants. Participants aged 35–45 years initiated ENVP-only use from non-current use (aHR 0.34; 95% CI: 0.23–0.51) at a lower rate than those aged 18–34 years. Compared to non-Hispanic White participants, non-Hispanic Black participants initiated ENVP-only use from never use at a higher rate (aHR 4.39; 95% CI: 2.09–9.25).
Conclusion
Rapid response surveys can provide important preliminary information on tobacco use transition patterns while we wait for the slower release of nationally representative survey data.
What this paper adds
What is already known on this topic
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The use of electronic nicotine vapor products (ENVPs) has continued to evolve over time—as well as attitudes towards them—but the release of data from large nationally representative surveys often lags behind these changes.
What this study adds
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The Rutgers Omnibus Study provides rapid response data on tobacco use trends.
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Transition probabilities between tobacco use states remained relatively stable over time. Participants in this sample frequently switched between tobacco products, but those using both cigarettes and ENVPs were very likely to continue using one or both products.
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Female participants began using cigarettes at lower rates than male participants, participants ages 35–45 years began using ENVPs at a lower rate than participants ages 18–34 years, and non-Hispanic Black participants initiated use of ENVPs at a higher rate than non-Hispanic White participants.
How this study might affect research, practice or policy
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Rapid response tobacco use surveys can help fill the gap in product use trends and transitions while we await the slower release of nationally representative data, such as the Population Assessment of Tobacco and Health (PATH) Study.
