Single, Dual, and Poly Use of Tobacco Products, and Associated Factors Among Adults in 18 Global Adult Tobacco Survey Countries During 2015–2021

We report prevalence estimates of single, dual, and poly tobacco product use and the associated factors in 18 Global Adult Tobacco Survey (GATS) countries (2015–2021). We computed the number of tobacco products currently consumed (daily or non-daily) by survey participants using GATS microdata. County-level weighted prevalence rates of single, dual (any two), and poly (more than two) tobacco product users were calculated. Demographic, socioeconomic, and tobacco control-related factors associated with single, dual, and poly use were tested using multi-level multinomial regression analyses. Single (4.3–31.5%), dual(0.2–4.3%), and poly (0–0.8%) use varied across 18 countries. Smoke-free homes, knowledge about and exposure to information on the dangers of tobacco, and health warnings were associated with dual and poly use. Findings suggest the need for monitoring dual and poly use as new tobacco products emerge and provide leads to smoke-free policies and health promotion interventions to improve tobacco control.