Distinct Motives for Use Among Polytobacco Versus Cigarette Only Users and Among Single Tobacco Product Users

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Abstract
Alternative tobacco product (ATP) use as well as co-use of various tobacco products has increased in recent years, particularly among young adults. However, little is known about the differential role of motives for ATP or polytobacco use. We examined (1) motives for tobacco use in relation to polytobacco versus cigarette only use and (2) motives for tobacco use in relation to levels of tobacco use across products. We analyzed data from past 30-day tobacco users at Wave 2 (Spring 2015) of a six-wave longitudinal study of 3418 students aged 18–25 years from seven U.S. colleges/universities. Variables included sociodemographics, tobacco use (cigarettes, little cigars/cigarillos [LCCs], smokeless tobacco [SLT], hookah, and e-cigarettes), and tobacco use motives (social, self-enhancement, boredom relief, and affect regulation). Multivariate analyses found that boredom relief motives were associated with polytobacco use versus cigarette only use (p = .007). Higher consumption levels demonstrated the following associations: cigarettes—positively with boredom relief (p = .025) and affect regulation motives (p < .001); LCCs—positively with affect regulation motives (p = .035); SLT—negatively with social (p = .003) and positively with self-enhancement (p = .017) and boredom relief motives (p = .007); and hookah—positively with social (p = .002) and boredom relief motives (p = .033) and negatively with self-enhancement (p = .004) and affect regulation motives (p = .001). Distinct motives for use were associated with polytobacco use among smokers. Moreover, higher levels of use among single product users also demonstrated distinct associations across use motives. These data should inform targeted cessation interventions addressing motives for use in ATP and polytobacco users. Interventionists, public health practitioners, and health care providers must address the increasing issue of ATP and polytobacco use and tailor interventions to reduce ATP and polytobacco use in light of the distinct motives for use.

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