LAUSR

Key Points Question What are the trajectories of multiple nicotine product use among US youths? Findings In this 4-wave, nationally representative survey study that included 10 086 youths, 6 trajectories with weighted proportions emerged: nonuse (8056 [78.2%]), experimentation (908 [9.8%]), increasing e-cigarette/cigarette use (359 [4.0%]), increasing cigarette/cigar use (320 [3.3%]), decreasing cigarette/e-cigarette/cigar use (302 [3.2%]), and stable smokeless tobacco/cigarette use (141 [1.6%]). Meaning These results highlight the heterogeneity of longitudinal pathways of multiple nicotine product use among youths in the US and suggest directions for future prevention and regulatory efforts directed at nicotine product use behaviors in this population.