The pattern of experimentation with tobacco products has changed considerably over the past decade, with adolescents and young adults now commonly experimenting with multiple tobacco products. From 2016 to 2019, lifetime cigarette smoking among US high school seniors declined from 28.3% to 22.3%, whereas lifetime electronic cigarette (e-cigarette) use increased from 38.8% to 45.6%.4 However, US daily cigarette smoking prevalence was stable from 2007 to 2013 at 16% to 17%.5,6 It remains unclear how the rise in multiple tobacco product experimentation will impact future daily cigarette smoking prevalence. A scenario of concern is that those experimenting with multiple products may be more likely to transition to daily cigarette smoking,7,8 leading to an increase in this most harmful form of tobacco use.

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