Use of Conventional and Alternative Tobacco and Nicotine Products Among a Sample of Canadian Youth.

PURPOSE The purpose of this study was to examine the use of conventional and alternative tobacco and nicotine products among secondary school students. METHODS Respondents were 44,163 grade 9-12 students who participated in Year 2 (2013-2014) of COMPASS, a cohort study of 89 purposefully sampled secondary schools in Ontario and Alberta, Canada. Past-month use of various tobacco and nicotine products was assessed, as well as correlates of use, using a generalized linear mixed effects model. RESULTS Overall, 21.2% of the sample reported past-month use of any tobacco or nicotine product, with 7.2% reporting past-month use of e-cigarettes. E-cigarette users reported significantly greater prevalence of current use for all products. Students who were male, white, had more spending money, and had a history of tobacco use were more likely to report past-month use of e-cigarettes. CONCLUSIONS Approximately one fifth of youth reported past-month use of a nicotine product, with e-cigarettes being the third most common product. Overall, the findings suggest a rapidly evolving nicotine market.