Smokeless tobacco use among male adolescents: Patterns, correlates, predictors, and the use of other drugs

doi:10.1016/0091-7435(87)90039-9

Preventive Medicine

Volume 16, Issue 3, May 1987, Pages 385-401

https://doi.org/10.1016/0091-7435(87)90039-9 Get rights and content

Abstract

Questionnaire data from a sample of 3,023 adolescents indicated that over 60% of boys have tried smokeless tobacco, and 7% use it daily. Daily users reported an average of 5.3 uses per day. Among boys the prevalence of smokeless tobacco use in the past 6 months (18.8%) was higher than that for cigarette use (10.4%). For 86% of boys, the initial use of smokeless tobacco occurred in a social setting with other boys. Split-sample discriminant analyses identified peer use of smokeless tobacco as a discriminator between users and nonusers. Male triers of smokeless tobacco were discriminated from those who had never tried it by whether they had also tried smoking, intended to smoke, or had peers who used smokeless tobacco. Nine-month longitudinal data indicated that onset of smokeless tobacco use was not well predicted. Among daily users, the initial rate of use was the best prospective predictor of rate of use at follow-up (r = 0.576). Smokeless tobacco use was related to the use of other drugs, with 83% of male daily users indicating concurrent use of alcohol, marijuana, and/or cigarettes (τ = 0.354, 0.210, and 0.284, respectively). The use of smokeless tobacco was a prospective risk factor for the onset or increased use of cigarettes, alcohol, or marijuana.

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2009, Drug and Alcohol Dependence
Qualitative research suggests that a shared route of administration (i.e. via inhalation) for the common forms of both tobacco (i.e. cigarettes) and cannabis (i.e. joints) may contribute to their co-occurring use.
We used data on 43,093 U.S. adults who participated in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether cannabis use and abuse/dependence were associated with smoked (cigarettes, cigars, pipes) versus smokeless (snuff, chewed tobacco) forms of tobacco use, even after controlling for socio-demographic, psychiatric and substance-related covariates.
Tobacco smoking was associated with a 3.3–4.5 times increased risk for cannabis use and abuse/dependence respectively. After covariate adjustment, importantly for nicotine dependence, smoking tobacco (but not smokeless tobacco) was still significantly associated with both cannabis use (multinomial odds-ratio (MOR) 1.99) and cannabis dependence (MOR 1.55). In contrast, use of smokeless tobacco was not significantly correlated with elevated rates of cannabis use (MOR 0.96) or abuse/dependence (MOR 1.04).
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2003, Preventive Medicine
To describe patterns and correlates of tobacco product use other than cigarettes in adolescents 12–17 years of age.
Adolescent respondents (N = 6090) to the 1999 California Tobacco Survey provided estimates of ever and current use (in last 30 days) of smokeless tobacco, cigars, and bidis, which were examined by cigarette smoking experience, demographics, and known predictors of cigarette use.
Only 3% of adolescents who never smoked cigarettes experimented with other tobacco products. Among ever smokers who were not current smokers, the rate was 35%. Nearly 60% of current cigarette experimenters had tried another tobacco product, but almost 90% of current established smokers had experimented with one. Over 40% of current established smokers used another tobacco product in the last 30 days. Factors predictive of cigarette smoking were also highly associated with other tobacco use. In ever cigarette smokers, having peers who used other tobacco products was most highly associated with other tobacco use. Problem or risky behaviors, beliefs that cigarettes are safe or beneficial, and receptivity to tobacco promotions were also independently associated with other tobacco product use.
Adolescent smokers who use other tobacco products may be prone to risky behavior and such use may hasten the development of nicotine tolerance.
Snuff use and smoking in U.S. men: Implications for harm reduction
2002, American Journal of Preventive Medicine
Background: Encouraging smokers to switch to snuff may have unintended public health implications. This study examined the associations between snuff use and smoking in a representative sample of U.S. men.
Methods: Subjects were males aged ≥18 years in the National Health Interview Survey (N=13,865). The data analysis was conducted between August 2001 and April 2002. Multiple logistic regression modeling was used to examine the association between using snuff and quitting smoking.
Results: In 1998, 26.4% of U.S. men smoked, 3.6% used snuff, and 1.1% used both products. Adjusting for age and race/ethnicity, current smoking was most prevalent among males who used snuff on some days (38.9%) and lowest among those who used snuff every day (19.2%). Daily snuff users were significantly more likely than never-users to have quit smoking in the preceding 12 months (odds ratio [OR]=4.23; 95% confidence interval [CI]=2.16–8.28). However, U.S. men were more likely to be former snuff users who currently smoked (2.5%) than to be former smokers who currently used snuff (1.0%). Occasional snuff users (some day users) were more likely than never users to have tried to quit smoking in the preceding year (OR=1.69; 95% CI=1.04–2.76) but tended to be less likely to succeed (OR=0.50; 95% CI=0.19–1.33).
Conclusions: Some men may use snuff to quit smoking, but U.S. men more commonly switch from snuff use to smoking. Some smokers may use snuff to supplement their nicotine intake, and smokers who also use snuff are more likely than nonusers to try to quit smoking but tend to have less success.
Concomitant use of cigarettes and smokeless tobacco: Prevalence, correlates, and predictors of tobacco cessation
2002, Preventive Medicine
Background. This study examined the characteristics, tobacco use patterns over time, and predictors of tobacco cessation among concomitant users of cigarettes and smokeless tobacco.
Methods. Participants were employed adults residing in the southeastern United States who participated in the Working Well cancer prevention trial. Participants were assessed at baseline and followed-up 4 years later.
Results and Conclusions. The study yielded several key findings: (a) the prevalence of concomitant smoking and smokeless tobacco use was high among males and nonexistent among females, (b) the characteristics of concomitant users were relatively distinct from those of both smokers and smokeless tobacco users, (c) concomitant users exhibited substantial variability in their tobacco use patterns and were less likely to stop using tobacco than were smokers or smokeless tobacco users, (d) indicators of nicotine dependence predicted tobacco cessation for both smokers and smokeless tobacco users, but were largely unrelated to tobacco cessation among concomitant users, and (e) demographics, environmental variables, and measures derived from the transtheoretical model were not consistent predictors of tobacco cessation after controlling for nicotine dependence.
Dual tobacco use among Native American adults in southeastern North Carolina
2001, Preventive Medicine
Objective. While patterns of smokeless tobacco (ST) use and cigarette smoking are well documented, the epidemiology of simultaneous use of both tobacco products is less well studied, particularly among Native American populations. This study examines correlates of dual tobacco use among Lumbee Indian adults in southeastern North Carolina.
Methods. A telephone survey among 400 adult Lumbee Indians in Pembroke, North Carolina, collected information on demographics, current tobacco use, amounts of tobacco used, and tobacco related attitudes.
Results. total of 241 (60.3%) individuals did not cur rently use tobacco, 104 (26%) currently smoked, 74 (18.5%) currently used ST, and 19 (4.8%) used both products. Thus, 19 of 104 (18.3%) current smokers and 19 of 74 (25.7%) current ST users reported dual tobacco use. Compared to exclusive users of either tobacco product, dual tobacco users were intermediate in age and frequency of church attendance, had lower levels of education, and were the highest proportion of subjects reporting no friends and few close relatives. There was no difference by gender or marital status by tobacco use categories. While exclusive cigarette smokers reported smoking more cigarettes per day than dual tobacco users, overall, dual tobacco users had higher estimated daily nicotine exposure levels. Logistic regression analysis showed that younger age and infrequent church attendance predicted exclusive cigarette smoking, while older age and less education predicted exclusive ST use. Dual tobacco use was predicted only by less education.
Conclusions. Simultaneous use of ST and cigarettes is comparatively more common among Lumbee Indian adults than the general population and has an epidemiology distinct from either exclusive cigarette smoking or ST use. These data are the first to explore social support as well as tobacco-related attitudes among dual tobacco users in a Native American population. Recognition of these patterns of dual tobacco use would be important in any future tobacco intervention among Lumbee Indian adults.
Prevalence and correlates of smokeless tobacco use in a sample of Connecticut students
2000, Journal of Adolescence
We examined the prevalence of smokeless tobacco use, and its relationship to other risky behaviors in Connecticut school children in grades four through 12 (n=31,861). Less than one per cent of students in grades 4–8, and four per cent of those in grades 9–12, used smokeless tobacco. Eighty-two percent of all users were white males. Among high school males, the prevalences of risk-taking behaviors and feelings of stress and depression were significantly higher among users than non-users. Among high school males, the highest prevalences of risky behaviors and stress indicators were reported by joint users of cigarettes and smokeless tobacco.

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^☆: Supported by Grants HD13409 and HD15825 from the National Institute of Child Health and Human Development, by Grant CA 38273 from the National Cancer Institute, and by Grants DA 03635 and DA 03706 from the National Institute on Drug Abuse.

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General articleSmokeless tobacco use among male adolescents: Patterns, correlates, predictors, and the use of other drugs☆

Abstract

Prev. Med.

Addict. Behav.

J. Amer. Dental Assoc.

Prev. Med.

Addict. Behav.

Lancet

Addict. Behav.

Onset and cessation in adolescent cigarette smoking: A prospective analysis

Unpublished manuscript

Influence of an objective measure on self-reports of behavior

J. Appl. Psychol.

Smokers of low-yield cigarettes do not consume less nicotine

New Engl. J. Med.

Structure of problem behavior in adolescence and young adulthood

J. Consult. Clin. Psychol.

Increasing the validity of self-reports of smoking behavior in children

J. Appl. Psychol.

General article
Smokeless tobacco use among male adolescents: Patterns, correlates, predictors, and the use of other drugs☆