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Population Assessment of Tobacco and Health (PATH) Study

Revised December 2019

What is the PATH Study?

The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative longitudinal study of tobacco use and health in the United States. A collaboration between the National Institutes of Health (NIH) National Institute on Drug Abuse (NIDA) and the U.S. Food and Drug Administration (FDA) Center for Tobacco Products, the study was launched in 2011, started the first wave of data collection in 2013, and completed its fourth wave in late 2017.

Science Spotlight: E-cig ads and cigarette smoking in youth (March 26, 2018)

By following study participants over time, the PATH Study helps scientists learn how and why people start using tobacco products, quit using them, and start using them again after they’ve quit, as well as how different tobacco products affect health outcomes (such as cardiovascular and respiratory health) over time. Most participants complete the study questionnaire every other year.

The National Institutes of Health (NIH) and FDA announce the availability of the public-use questionnaire data files from the fourth wave of the Population Assessment of Tobacco and Health (PATH) Study. This latest addition to the PATH Study’s Public-Use Files (PUF) contains data collected during Wave 4 (December 2016 – Jan 2018). These PUFs may be downloaded from the PATH Study Public Use Files Webpage. Beginning in 2020, there will be a series of special collection PATH Study data releases. The first special collection data release will consist of data collected only from youth respondents between Waves 4 and 5 of the PATH Study. In addition, the Biospecimen Access Program (BAP) site provides information on how to access the urine, serum, and plasma collected from adult PATH Study participants during Wave 1 and Wave 2.  

The PATH Study is a household-based, nationally representative, longitudinal cohort study of youth (12-17 years old) and adults in the United States. The study was launched in 2011 to inform FDA’s regulatory activities under the Family Smoking Prevention and Tobacco Control Act. For the latest announcements, data releases and updates, new publications, upcoming events, and other information for PATH Study data users, join the PATH Study Data User Forum. The forum enables researchers using PATH Study data to submit and answer questions.

Study Team

Scientists at NIDA and the FDA are leading the PATH Study. They are working with Westat, a research company with expertise in survey design, questionnaire development, data collection, and analysis. Westat also manages a team of partner organizations working on the Study.

The Principal Investigator of the PATH Study is located at Roswell Park Comprehensive Cancer Center. Other participating scientists are from:


By monitoring and assessing behaviors, attitudes, biomarkers, and health outcomes associated with tobacco use in the United States, the PATH Study helps enhance the evidence base informing FDA’s regulatory activities related to tobacco. Specifically, the study aims to:

  • Examine susceptibility to tobacco product use;
  • Study the progression of tobacco product use, including initiation, dependence, cessation, and relapse;
  • Evaluate patterns of tobacco use, including:
    • use of newer products, such as e-cigarettes or ENDS (electronic nicotine delivery systems);
    • poly-use;
    • switching products;
  • Track potential behavioral and health impacts, including biomarkers of exposure and potential harm; and
  • Assess differences in tobacco-related attitudes, behaviors, and health conditions among racial/ethnic, gender, and age subgroups over time.

Initial Findings

About 46,000 people aged 12 years and older, including tobacco users and non-users, were included in the first wave of the PATH Study.

Initial data on adult and youth tobacco use, published January 2017 in the New England Journal of Medicine, showed that more than 25 percent of American adults were current users of tobacco in 2013-14 and roughly 9 percent of youth reported using tobacco in the past 30 days. Multiple product use was common among tobacco users, accounting for roughly 40 percent of adult and youth tobacco users, with cigarettes and e-cigarettes being the most common combination among both age groups.

Among tobacco users who reported using more than one product:

  • 23 percent of adults and 15 percent of youth used cigarettes and e-cigarettes
  • 6 percent of adults and 4 percent of youth used cigarettes and hookah
  • 2 percent of adults and 5 percent of youth used e-cigarettes and hookah
  • 5 percent of adults and 10 percent of youth used cigarettes and cigarillos

The study reports prevalence for additional product combinations used by study participants.

Data Access

Data and documentation (questionnaires, codebooks) related to the PATH Study are available at the study website at the National Addiction & HIV Data Archive Program (NAHDAP), including instructions for access to restricted- and public-use files:

  • Questionnaire Public-use files (PUFs)
    From Wave 1 (Sep 2013–Dec 2014), Wave 2 (Oct 2014–Oct 2015), Wave 3 (Oct 2015-Oct 2016), and Wave 4 (Dec 2016-Jan 2018).
  • Questionnaire Restricted-use files (RUFs)
    From Wave 1 (Sep 2013–Dec 2014), Wave 2 (Oct 2014–Oct 2015), Wave 3 (Oct 2015 - Oct 2016), and Wave 4 (Dec 2016-Jan 2018).
  • Biomarker Restricted-use files (BRUFs)
    From Wave 1 (Sep 2013–Dec 2014) and Wave 2 (Oct 2014–Oct 2015).
  • State Identifier Restricted-use files (SIRUFs)
    From Wave 1 (Sep 2013–Dec 2014).

Data from additional waves will be released as they become available.

Biospecimen Access Program (BAP)

Biospecimens collected from PATH Study participants are also available to the research community. Investigators proposing meritorious and feasible studies consistent with PATH Study objectives or research priorities for tobacco regulatory science will be given highest priority for access to these biospecimens. Proposals addressing other objectives that advance the knowledge of tobacco use or tobacco-related health outcomes will also be considered. There are two submission and review cycles per year, beginning in September and May. Application instructions and deadlines are available at the PATH Study webpage on the NAHDAP website:

  • Biospecimen Access Program (BAP)
    Access to urine and blood collected from adult PATH Study participants in Waves 1 and 2, and DNA collected from adult PATH Study participants in Wave 1.

Journal Publications

Listed below is a selection of peer-reviewed journal articles using data from the PATH Study. See the PATH Study website at NAHDAP or search PubMed.gov for a complete list of publications.

Additional Resources


Contact PATHStudyinfo@westat.com.

This page was last updated December 2019

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