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A common criterion for being labeled a “never smoker” is having smoked <100 lifetime cigarettes. This category is often used as an unexposed reference group to estimate the relative harm from cigarettes. We examined the amount of current and past cigarette and non-cigarette tobacco/nicotine use among adults who met this “never smoker” criterion.

We analyzed cross-sectional data from 17 179 adult “never smokers” (ie, reported <100 lifetime cigarettes) in Wave 4 (2016–2018) of the Population Assessment of Tobacco and Health (PATH) Study, a United States nationally representative sample. We used PATH-derived variables to describe “never smokers’” demographics as well as cigarette and non-cigarette tobacco/nicotine use.

Approximately half of “never smokers” were young adults (49.3%). Most were white (68.6 …