Dual use of cigarettes and other tobacco products in the high-tobacco-burden states

Dual use of cigarettes and e-cigarettes

Respondents’ use of both cigarettes and e-cigarettes by current/ former/ never use status in the 13 high-tobacco-burden states is high, with a large proportion of respondents reporting dual use cigarettes and e-cigarettes (44.0%), suggesting significant overlap in use.

Dual use of cigarettes and cannabis (any form)

Dual use of cigarettes and cannabis is common, with nearly 40% of current cigarette users also reporting current cannabis use. Individuals who reported current cigarette use also had the lowest proportion of reporting never using cannabis at 7.7%.

Dual use of cigarettes and any smokeless tobacco (chew, snuff, oral nicotine pouches)

Over 41% of users reporting dual use of cigarettes and at least one form of smokeless tobacco including chew, snuff, oral nicotine products. Only 13.4% of current cigarette users had never used smokeless tobacco, indicating high crossover.

Dual use of cigarettes and all other combustible tobacco (cigarillos, hookah, cigars)

A large majority (84.3%) of current cigarette users also reported using other combustible tobacco products such as cigars, cigarillos, or hookah. This was the highest dual-use rate observed across all tobacco product combinations.