Objective: To examine the relationship between adolescents' cigarette smoking experiences and alternative tobacco product (ATP) use.
Methods: Multiple indicators and multiple causes (MIMIC) models estimated simultaneously the relationship between cigarette smoking experiences and ATP use among high school students (N=1827) completing the 2009 Virginia Youth Tobacco Survey.
Results: Overall, ATP use was associated with adolescents' ever use of cigarettes, early onset of cigarette smoking, cigarettes smoked per day, and peer smoking; however, important model differences between racial/ethnic groups were observed.
Conclusions: Prevention and cessation programs might reduce adolescent ATP use by targeting specific characteristics of cigarette smoking.