Types of Dual and Poly-Tobacco Users in the US Military

Melissa A. Little, Zoran Bursac, Karen J. Derefinko, Jon O. Ebbert, Gerald W. Talcott, Ann Hryshko-Mullen, Robert C. Klesges

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


The present investigation was designed to determine the prevalence and types of dual and poly-use of tobacco products in the US Air Force, as well as characteristics and factors associated with these types. We conducted a cross-sectional assessment of tobacco-product use among 13,873 Air Force trainees from 2013 to 2014. The assessment included prevalence of the use of 10 different tobacco products and demographic and environmental factors, such as risk perceptions of tobacco use, peer use, and tobacco-company influences. Latent class analysis was carried out to determine types of poly-tobacco users. Tobacco-product use was reported by 27.1% of participants, and of those, over half reported using more than 1 tobacco product. Latent class analysis indicated 5 classes of poly-tobacco use. Factors associated with poly-tobacco (vs. mono-tobacco) use included lower confidence to remain tobacco-free, low harm perceptions, and receiving tobacco products free at bars or social events. Rates of dual and poly-tobacco use are high among trainees, and while these groups are similar to mono users in some ways, there are a number of differences that need to be considered when developing targeted interventions to address use of multiple tobacco products.

Original languageEnglish (US)
Pages (from-to)211-218
Number of pages8
JournalAmerican journal of epidemiology
Issue number3
StatePublished - Aug 1 2016


  • alternative tobacco products
  • dual tobacco use
  • military personnel
  • poly-tobacco use
  • risk factors
  • smokeless tobacco
  • smoking
  • tobacco

ASJC Scopus subject areas

  • Epidemiology


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