Many American adults and teens still use tobacco products, despite all the well know dangers. Researchers looked at more than 46,000 people and found that 28% of American adults currently use some form of tobacco, while 9% of teens said they used tobacco in the past month.

Tobacco products included cigarettes, cigars, cigarillos, filtered cigars, pipe tobacco, hookahs, snus pouches and other smokeless tobacco. Even more worrisome, 40% of tobacco users turned to more than 1 product, with cigarettes and e-cigarettes being the most common combination.

“We know with certainty that cigarette smoking is incredibly harmful,” said lead researcher Andrew Hyland. He is chairman of the department of health behavior at Roswell Park Cancer Institute in Buffalo, N.Y. “Cigarette smoking is responsible for 480,000 deaths in the U.S. each and every year, but getting completely off cigarettes quickly leads to improved health,” he said. According to the study, cigarette smoking continues to remain the most common form of tobacco use.

E-cigs trailed only cigarettes in popularity for both youths and adults, and hookah smoking was very high among 18 to 24 year-olds. Among adults, 23% smoked cigarettes and 7% of those smokers also used e-cigs. Among kids aged 12 to 17, just over 13% smoked regular cigarettes, while 11% used e-cigs as well..

Man is holding vaporizer and conventional tobacco cigarettes and comparing or offering.This study underscores the importance for fully implementing the Tobacco Control Act, said Erika Sward, assistant vice president for national advocacy at the American Lung Association. “The act specifically tasks FDA with looking at tobacco use and whether or not certain products or actions by companies would cause people to switch instead of quit,” she said. “These findings call into question any positive impact e-cigarettes might have on public health,” Sward said.

The lung association is concerned about people using both cigarettes and e-cigarettes, she added. “We recognize that in many ways, at least for the larger tobacco companies, e-cigs are a way for people to keep using their ‘cash cow’ product, which is regular cigarettes,” Sward said. “It’s another way to discourage smokers from ending their tobacco addiction for good.”

Tobacco use is not declining in absolute terms, it is declining as a percent of the overall population due to population growth. The number of smokers still using tobacco has remained roughly the same for a while.

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