INTRODUCTION: Use of more than one tobacco product among college students is increasing in popularity, leading to nicotine addiction and additional health risks. The study (1) examined polytobacco use patterns among college students who had ever used tobacco; and (2) assessed the sociodemographic and personal factors associated with current polytobacco use, compared to current single product use and former tobacco use among college students.

METHODS: Of 10,000 randomly selected college students from a large public university in the Southeast, a sample of 1593 students age 18 or older completed an online survey assessing tobacco use and attitudes. Ever tobacco users were included in this study (n = 662, or 41.6% of survey completers).

RESULTS: About 15% of ever users reported current polytobacco use, and more than 70% of polytobacco users smoked cigars, little cigars, or clove cigarettes in combination with one or more products. Cigarettes were the most commonly-used product among single users, followed by hookah. Males, underclassmen, and students with greater acceptance of cigarette use were more likely to be polytobacco users. Race/ethnicity was marginally related to polyuse status, with white/non-Hispanics 28% less likely to be polytobacco users versus single product users.

CONCLUSIONS: Polytobacco users were more likely than single users to consume emerging tobacco products, (ie, hookah and electronic cigarettes). Males, underclassmen, and racial/ethnic minorities were more at risk for polytobacco use. As young people are particularly prone to nicotine addiction, there is a need to further investigate polytobacco use among college students.

Document Type


Publication Date


Notes/Citation Information

Published in Nicotine & Tobacco Research, v. 18, issue 2, p. 163-169.

© The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Nicotine & Tobacco Research following peer review. The version of record, Karen M. Butler, Melinda J. Ickes, Mary Kay Rayens, Amanda T. Wiggins, and Ellen J. Hahn. Polytobacco Use Among College Students. Nicotine & Tobacco Research, (2016) 18 (2): 163-169, is available online at: http://dx.doi.org/10.1093/ntr/ntv056

Digital Object Identifier (DOI)


Funding Information

The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1TR000117.