Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
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E-cigarette use occurs with tobacco product use in youth. ⋯ Our study highlights the complexity of tobacco use patterns in US middle and high school students. Future studies addressing the full public health impact of movement into or out of combustible tobacco use will require longitudinal data with appropriate measures of tobacco and e-cigarette product-specific use (eg, frequency and intensity), as well as adequate sample size and a sufficient number of waves to determine how use of individual products, like e-cigarettes, impact progression into or out of more stable patterns of tobacco and e-cigarette use.