United States of America USA

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 (4CV3) Survey, to investigate the relationship between nicotine vaping products (NVPs) and/or heated tobacco products (HTPs) and cigarette use, and to inform emerging policies related to NVPs and/or HTPs. Three survey waves of the 4CV Survey have been conducted among adult smokers, recent former smokers, vapers, and HTP users in the US as well as in Australia, Canada, and England. These four countries have similar cigarette-smoking rates, but divergent policies on vaping product and/or 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 2,733 (800 Smokers, 232 Quitters, 174 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 May 15, 2020 2,507 (1,202 Smokers, 245 Quitters, 407 NVP Users, 653 Dual Smoking-NVP/HTP Users)

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