Methods: We combined the 2002 and 2004 National Youth Tobacco Survey (NYTS) for our analysis. The NYTS data was designed to provide nationally representative data for middle and high school students in grades 6 to 12. Overall, and demographic-specific population estimates of current cigarette use and current polytobacco use, defined as being a current cigarette smoker and a current user of cigars, smokeless tobacco, pipes, bidis, and/or kreteks, were determined. Additionally, different combinations of products being used and predictor variables associated with polytobacco use were identified.

Results: The overall prevalence was 16.2% for cigarettes. Among adolescent cigarette smokers, 46.5% were polytobacco users, with most using 1 other tobacco product. Polytobacco use was more common among male cigarette smokers (62.4%) than among female cigarette smokers (31.2%). Among all adolescents using cigarettes and 1 other tobacco product, the more popular combinations were cigarettes and cigars (68.0%) or cigarettes and smokeless tobacco (17.2%). Polytobacco users were more likely to be influenced by peer tobacco use, industry advertising, and have favorable beliefs towards cigarette smoking as compared to cigarette only users.

Conclusions: Almost half of all adolescent cigarette smokers used other tobacco products; about two-thirds of male smokers were polytobacco users and one-third of female smokers were polytobacco users. Interventions that focus on individual tobacco product use may not be effective, given the level of polytobacco use among youth