Use patterns and heath effects associated with various scenarios for promotion of smokeless tobacco use as a safer alternative to cigarettes
| Scenario | Condition | Never user | Quit | Cigarettes | Smokeless | Dual | Quit ratio | Tobacco-related health effect (5% to 95%) | Health effect ratio (5% to 95%) |
| Base case | Figure 2 | 56.0% | 19.8% | 21.6% | 1.0% | 1.6% | 47.9% | 24.2 (21.5 to 27.1) | |
| Aggressive smokeless promotion | Initiation: Increase smokeless initiation ×10; half from cigarettes, half from never users | 38.0% | 19.3% | 10.5% | 12.6% | 19.6% | 64.8% | 30.5 (25.7 to 35.5) | 1.26 (1.10 to 1.44) |
| Health concerned: Increase smokeless use ×10, half from cigarettes, half from quitters. Fraction of dual use among new smokeless users: 0.25. | |||||||||
| Smokefree environment: Cut quitting in half. Fraction of cigarette users to smokeless: 0.50. Fraction of dual use among new smokeless users: 0.75. | |||||||||
| Price sensitive: Cut quitting in half and move to smokeless. Fraction of cigarette users to smokeless: 0.50. Fraction of dual use among new smokeless users: 0.25. | |||||||||
| US Smokeless Tobacco Company (USST) | Increase smokeless initiation ×3.7. Other assumptions remain the same | 50.6% | 18.7% | 13.5% | 6.6% | 10.6% | 57.9% | 24.7 (21.8 to 27.9) | 1.02 (0.96 to 1.09) |
| Aggressive promotion with most new users from smokers | Increase smokeless initiation ×10; 75% from smokers, 25% from never users. Other assumptions remain the same. | 47.0% | 15.4% | 7.2% | 11.9% | 18.5% | 68.1% | 25.9 (22.7 to 29.5) | 1.07 (0.96 to 1.21) |
| No effect on initiation | No change in initiation patterns. Other assumptions remain the same. | 56.0% | 18.4% | 14.8% | 4.1% | 6.7% | 55.3% | 22.3 (19.8 to 25.1) | 0.92 (0.89 to 0.95) |
| Alternative patterns of smokeless use (using older national data, with low levels of dual use)31 | |||||||||
| Alternate Base | Other probabilities same as figure 2 | 56.0% | 19.9% | 21.8% | 1.8% | 0.6% | 47.8% | 23.5 (20.8 to 26.5) | |
| Aggressive smokeless promotion | Same as above except for different smokeless use patterns | 38.0% | 20.1% | 11.8% | 20.4% | 9.7% | 63.0% | 23.8 (20.9 to 27.4) | 1.01 (0.93 to 1.11) |
| USST | Same as above except for different smokeless use patterns | 50.6% | 18.9% | 14.0% | 9.5% | 6.9% | 57.4% | 22.2 (19.7 to 25.2) | 0.95 (0.91 to 0.99) |
| Aggressive promotion with most new users from smokers | Same as above except for different smokeless use patterns | 47.0% | 16.2% | 8.5% | 19.8% | 8.5% | 65.4% | 19.2 (16.6 to 22.2) | 0.82 (0.73 to 0.91) |
| No effect on initiation | Same as above except for different smokeless use patterns | 56.0% | 18.5% | 15.0% | 4.9% | 5.7% | 55.2% | 21.6 (19.1 to 24.4) | 0.92 (0.89 to 0.95) |