The consumption of tobacco products, particularly combustible forms such as cigarettes and cigars, represents a persistent public health crisis responsible for numerous premature fatalities. Recently, electronic cigarette usage has shown a marked increase within the young adult demographic. As the leading cause of preventable mortality, tobacco consumption presents numerous health hazards, including its association with binge drinking—a behavior notably prevalent among young adults. While existing literature has established significant correlations between both combustible and electronic tobacco use and binge drinking behaviors, research examining the relationship between concurrent use of both tobacco types and binge drinking among college student populations remains insufficient. Addressing this research gap, the current study seeks to investigate the relationships between tobacco use patterns and binge drinking across distinct user categories among college students, specifically: non-users, exclusive electronic cigarette users, exclusive combustible tobacco users, and individuals who use both electronic cigarettes and combustible tobacco products concurrently.
This study analyzed data derived from the American College Health Association-National College Health Assessment (ACHA-NCHA) survey administered between Fall 2019 and Fall 2022, encompassing responses from 332,721 college students who reported alcohol and/or tobacco use. The analysis incorporated the following variables: the primary outcome measure assessed whether participants had engaged in binge drinking within the preceding two weeks; the independent variable categorized participants into four distinct groups: (1) non-tobacco users; (2) exclusive electronic cigarette users; (3) exclusive combustible tobacco users; and (4) dual users of both electronic cigarettes and combustible tobacco products; additionally, demographic characteristics were included as covariates. Multivariable logistic regression analyses were conducted to examine the associations between tobacco use categories and binge drinking behavior.
The sample distribution revealed that 81.9% of participants reported abstaining from tobacco use, while 8.1% reported exclusive electronic cigarette use, 3.8% reported exclusive combustible tobacco use, and 6.2% reported concurrent use of both electronic cigarettes and combustible tobacco products. Relative to non-tobacco users, students who exclusively used combustible tobacco (aOR = 3.41), exclusively used electronic cigarettes (aOR = 4.59), or engaged in dual use of electronic cigarettes and combustible tobacco (aOR = 8.21) demonstrated significantly elevated odds of binge drinking. Furthermore, when compared with exclusive combustible tobacco users, students who exclusively used electronic cigarettes exhibited significantly higher odds of binge drinking (aOR = 1.35), while those who engaged in dual use showed substantially greater odds (aOR = 2.41). Additionally, dual users demonstrated significantly increased odds of binge drinking compared with exclusive electronic cigarette users (aOR = 1.79).
Takeaway: Dual use of electronic cigarettes and combustible tobacco demonstrates a strong correlation with binge drinking behavior among college student populations, underscoring the necessity for additional research and interventions.