United States of America

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United States of America

The United States (US) is yet to ratify the WHO Framework Convention on Tobacco Control (FCTC) despite signing the FCTC on May 10, 2003. In 2002, a team of researchers from Australia, Canada, the United Kingdom, and the US launched the flagship ITC Four Country (4C) Survey. Nine survey waves of ITC 4C Survey have been conducted among a cohort of adult smokers aged 18 and older in the US. In 2016, the team expanded the cigarette smoking 4C survey into the ITC Four Country Smoking and Vaping Survey, to investigate the relationship between nicotine vaping products (NVPs) and/or heated tobacco products (HTPs) and cigarette smoking among adult smokers, recent former smokers, vapers, and HTP users in Australia, Canada, England, and the United States, and to inform emerging policies related to NVPs and/or HTPs. These four countries have similar cigarette-smoking rates, but divergent policies on vaping product/HTP use.

Survey Overview

Survey Mode: Computer Assisted Telephone Interview (CATI) and/or Web Interview
Wave	Survey Dates	Survey Sample Size
4C1-US	October 30 to December 30, 2002	2,138 Smokers
4C2-US	May 16 to September 28, 2003	2,028 (1,912 Smokers and 116 Quitters)
4C3-US	June 3 to December 27, 2004	2,088 (1,939 Smokers and 149 Quitters)
4C4-US	October 10, 2005 to January 31, 2006	2,004 (1,808 Smokers and 194 Quitters)
4C5-US	October 11, 2006 to February 17, 2007	2,034 (1,810 Smokers and 224 Quitters)
4C6-US	September 21, 2007 to February 12, 2008	2,002 (1,766 Smokers and 236 Quitters)
4C7-US	October 25, 2008 to July 28, 2009	1,763 (1,518 Smokers and 245 Quitters)
4C7.5-US	November 2, 2009 to January 10, 2010	678 Smokers and Quitters Note: This was a US-only interim wave.
4C8-US	July 13, 2010 to June 24, 2011	1,520 (1,272 Smokers and 248 Quitters)
4C9-US	August 28, 2013 to March 31, 2015	5,219 Adults (4,938 Smokers and 281 Quitters), 1,208 Youth (12-17y)* (*US sample expanded to include adult nicotine users/non-users, and youth users/non-users)
Survey Mode: Web Interview
Wave	Survey Dates	Survey Sample Size
4CV1-US	July 7 to September 30, 2016	2,812 (1,070 Smokers, 310 Quitters, 175 NVP Users, and 1,257 Dual Smoking-NVP Users)
4CV2-US	February 23 to July 9, 2018	2,846 (1,109 Smokers, 343 Quitters, 362 NVP Users, and 1,032 Dual Smoking-NVP Users)
4CV3-US	February 24 to June 1, 2020	2,528 (1,202 Smokers, 264 Quitters, 407 NVP Users, 653 Dual Smoking-NVP/HTP Users)
4CV4-US	August 4 to December 19, 2022	2,107 (1,102 Smokers, 326 Quitters, 346 NVP Users, 333 Dual Smoking-NVP/HTP Users)
4CV5-US	July to October 2024	*Target N=2150

Partner Institutions

Related Resources

Contact Information

Thomas Agar, Project Manager-Research Associate
Email: tkagar@uwaterloo.ca

Anne C.K. Quah, Managing Director and Senior Research Scientist
Email: ackquah@uwaterloo.ca

K. Michael Cummings, Principal Investigator (ITC Four Country—US Waves 1-9 Surveys and ITC Four Country Smoking and Vaping—US Waves 1-3 Surveys)
Email: cummingk@musc.edu

Andrew Hyland, Principal Investigator (ITC Four Country Smoking and Vaping—US Waves 4-6 Surveys)
Email: Andrew.Hyland@roswellpark.org

Countries

International Tobacco Control (ITC) Policy Evaluation Project
Department of Psychology
University of Waterloo
200 University Avenue West
Waterloo, Ontario, N2L 3G1 Canada

Email: itc@uwaterloo.ca
Phone: +1 519-888-4567 ext. 43597

The University of Waterloo acknowledges that much of our work takes place on the traditional territory of the Neutral, Anishinaabeg and Haudenosaunee peoples. Our main campus is situated on the Haldimand Tract, the land granted to the Six Nations that includes six miles on each side of the Grand River. Our active work toward reconciliation takes place across our campuses through research, learning, teaching, and community building, and is centralized within the Office of Indigenous Relations.