More than one in four U.S. adults are current users of at least one type of tobacco product, and nearly 1 in 10 youths report using tobacco in the previous month, according to a report published in the Jan. 26 edition of the New England Journal of Medicine.

Analysis of data from 45,971 adults and youths aged 12 years and older in Wave 1 of the national longitudinal Population Assessment of Tobacco and Health (PATH) study showed 28% of adults were current users of tobacco products, and 20% were daily users. Cigarettes were the most commonly used tobacco product: 18% of adults said they were current users of cigarettes and 16% were daily users. Cigars and e-cigarettes were the next most common tobacco products, with 8% of adults currently using cigars, and 6% currently using e-cigarettes. (N Eng J Med. 2016, Jan 26. doi: 10.1056/NEJMsa1607538 ).

The overall prevalence of tobacco use in the previous 30 days among those aged 12-17 years was 9%. Among youths aged 15-17 years, 15% said they had used any tobacco product in the previous 30 days – 8% cigarettes, 58% e-cigarettes, and 5% cigars – while 3% reported daily tobacco use.

“Among adults, tobacco use was generally higher among younger adults, men, members of racial minorities, members of sexual minorities, those with lower educational attainment and lower household income, and those living in the South or Midwest than among their counterparts,” wrote Karin A. Kasza of the department of health behavior at the Roswell Park Cancer Institute, Buffalo, N.Y., and coauthors. “Among youths, the prevalences of ever use and use in the previous 30 days were higher among older youths, male youths, and members of sexual minorities than among their counterparts.”

Many also reported using combinations of tobacco products in the previous 30 days, with 23% of adults and 15% of youths using cigarettes and e-cigarettes concurrently.

The authors noted that the estimates of tobacco use among youths obtained from this household-based survey were lower than those seen in previous school-based surveys, and suggested the survey method may have influenced young people’s responses.

“Surveys administered in a school-based environment may overestimate tobacco-use behaviors because of peer influences, whereas youths may underreport tobacco-use behaviors in a home-based survey out of fear that their parents will overhear answers or learn about them from the interviewer,” Ms. Kasza and her associates wrote.

The study was supported by the National Institute on Drug Abuse, National Institutes of Health, and the Food and Drug Administration and U.S. Department of Health and Human Services under a contract to Westat. One author declared grant support from a pharmaceutical company and having acted as an expert witness against the tobacco industry. Another declared advisory board positions and grant support from private industry, and a third declared stock in private industry. No other conflicts of interest were declared.