Elsevier

Preventive Medicine

Volume 32, Issue 3, March 2001, Pages 262-267
Preventive Medicine

Regular Article
Evidence That Smokeless Tobacco Use Is a Gateway for Smoking Initiation in Young Adult Males

https://doi.org/10.1006/pmed.2000.0802Get rights and content

Abstract

Background. This study was designed to test the hypothesis that smokeless tobacco (SLT) serves as a gateway drug for smoking among young adult males.

Methods. A cohort (n = 7,865) of U.S. Air Force recruits who claimed to have never smoked cigarettes was followed prospectively for 1 year. The participants were male, 32.9% were ethnic minorities, and their average age was 19.84 years (SD = 2.29). Among recruits entering basic military training, 403 (5.1%) reported current SLT use and 198 (2.5%) reported a past history of SLT use.

Results. At the 1-year follow-up current SLT users were 233% more likely to have initiated smoking than nonusers (odds ratio = 2.33, 95% CI = 1.84–2.94). Similarly, recruits who reported past SLT use were 227% more likely to begin smoking than participants who had never used SLT (odds ratio = 2.27, 95% CI = 1.64–3.15). SLT use remained a potent predictor of smoking initiation in a multivariate logistic model that included demographic factors and other risk factors for initiation.

Conclusions. SLT use appears to be an important predictor of smoking initiation among young adult males. This study suggests that smoking prevention and cessation programs should also include strategies related to SLT use.

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    This paper was supported by a grant from the U.S. National Institutes of Health (HL-53478) awarded to the University of Memphis (R.C. Klesges, Principal Investigator). The views expressed in the article are those of the authors and are not the official policy of the U.S. Government, Department of Defense, or U.S. Air Force.

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    To whom requests for reprints should be addressed at Health Research Group, University of Missouri, Kansas City, 4825 Troost, Suite 124, Kansas City, MO 64110.

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