scholarly journals Exposure to a Tobacco-Specific Carcinogen Among Adolescent Smokeless Tobacco Users in Rural California, United States

2019 ◽  
Vol 22 (10) ◽  
pp. 1764-1771
Author(s):  
Benjamin W Chaffee ◽  
Peyton Jacob ◽  
Elizabeth T Couch ◽  
Neal L Benowitz
Keyword(s):  
United States ◽  
High School ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
The United States ◽  
Tobacco Product ◽  
Geometric Means ◽  
Tobacco Products ◽  
Smokeless Tobacco Products ◽  
Smokeless Tobacco Use

Abstract Introduction Approximately the same percentage of male high school students in the United States currently uses conventional smokeless tobacco as smokes cigarettes, resulting in toxin exposure. Methods This study assessed tobacco product use (smokeless, combustible, and electronic cigarettes) and nicotine and carcinogen exposures in a sample of 594 male rural high school baseball players—a population traditionally at risk for smokeless tobacco use. Salivary specimens were assayed for cotinine (a biomarker of nicotine exposure) and urine specimens for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a biomarker of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) using liquid chromatography–tandem mass spectrometry. Results The prevalence of past 30-day use of any tobacco product was 29%. Past 7-day smokeless tobacco use (prevalence: 13%) was associated with the highest levels of cotinine and NNAL observed in the sample, whether smokeless tobacco was used exclusively (geometric means: cotinine 11.1 ng/mL; NNAL 31.9 pg/mg-creatinine) or in combination with combustible products (geometric means: cotinine 31.6 ng/mL; NNAL 50.0 pg/mg creatinine). Cotinine and NNAL levels were incrementally higher in each increasing category of smokeless tobacco use frequency. However, observed levels were lower than previously reported for adults, likely reflecting less smokeless use per day among adolescents. Conclusions Based on these biomarker observations, adolescents who use conventional smokeless tobacco products are exposed to substantial levels of nicotine and NNK. Although exposed to lower levels than adult smokeless users, the findings are concerning given the young age of the sample and tendency for smokeless tobacco users to increase use intensity over time. Implications This study demonstrates that adolescents using smokeless tobacco are exposed to levels of nicotine and NNK that increase with use frequency and that exceed exposures among peers using other tobacco products. Youth smokeless tobacco use in the United States has not declined along with youth smoking prevalence, giving greater importance to this health concern. To reduce youth (and adult) exposures, needed actions include effective smokeless tobacco use prevention, potentially in combination with reducing the levels of harmful and potentially harmful chemicals in smokeless tobacco products currently popular among adolescents.

Characteristics of Smokeless Tobacco Use among High School Football Players as Related to Type of Smokeless Tobacco and Period of Use

1992 ◽  
Vol 22 (1) ◽  
pp. 69-85 ◽  
Author(s):  
Curtis J. Creath ◽  
J. Timothy Wright ◽  
John F. Wisniewski
Keyword(s):  
High School ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Demographic Characteristics ◽  
Football Players ◽  
High School Football ◽  
Tobacco Products ◽  
Chewing Tobacco ◽  
Smokeless Tobacco Products ◽  
Smokeless Tobacco Use

The present study was conducted to assess differences in the behavioral and demographic characteristics of snuff (dip) users as compared to users of chewing tobacco. High School football players (1116) were surveyed concerning their use and perceptions of smokeless tobacco. Adolescent athletes who tried smokeless tobacco were more likely to be white, to use cigarettes, alcohol, and cigars and to have family users than those who never tried. Initial use was highest before the age of fourteen years and was influenced by friends, curiosity and family. Dippers tended to initiate use because of friends, while chewers started because of family users. Users of both dip and chew started primarily because of curiosity. Users of both were more likely to consume greater amounts to alcohol and cigarettes and to smoke cigars and pipes. It appears that the longer smokeless tobacco is consumed, the more likely both dip and chew will be used. Users of smokeless tobacco for more than two years tended to consume more of the product each week, used it for more hours/day, initiated use at an earlier age, and used it more often at school and work than those using it for less than two years. Use of cigars/pipes, consumption of alcohol, and quantity of cigarette consumption increased significantly with longer duration of smokeless tobacco use. Intervention and prevention programs would be helped by understanding differences between users of various smokeless tobacco products and differences related to the duration of use. In addition, further analyses of smokeless tobacco users should study chewers, dippers, and users of both separately.

Smokeless Tobacco Use in the United States: Present and Future Trends

1985 ◽  
Vol 7 (2) ◽  
pp. 24-27 ◽  
Author(s):  
Ellen R. Gritz ◽  
Charles Ksir ◽  
William J. McCarthy
Keyword(s):  
United States ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
The United States ◽  
Future Trends ◽  
Smokeless Tobacco Use

Epidemiology of smokeless tobacco use in the United States and other countries

2020 ◽  
pp. 39-71
Author(s):  
Gretchen McHenry ◽  
Stephanie J. Parker ◽  
Dalia Khoury ◽  
Kevin P. Conway
Keyword(s):  
United States ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
The United States ◽  
Smokeless Tobacco Use

Patterns of Smokeless Tobacco Use by Young Adolescents

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 75-78
Author(s):  
Anita Gottlieb ◽  
Sandra K. Pope ◽  
Vaughn I. Rickert ◽  
Brian H. Hardin
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Educational Interventions ◽  
Young Adolescents ◽  
Tobacco Products ◽  
Smokeless Tobacco Products ◽  
Continued Use ◽  
Smokeless Tobacco Use

The use of smokeless tobacco products by adolescents has reportedly increased. The purpose of this study was to examine the use of smokeless tobacco by young adolescents across geographic locations and to look at patterns of use and variables associated with continued use beyond experimentation. Participants were 2018 students in sixth through ninth grades. Forty-five percent were male and 76% were white. Use of smokeless tobacco products was reported by 12% of the total population, and 25% reported smoking. Smokeless tobacco use was associated with cigarette smoking, alcohol use, and parental substance abuse. Those reporting alcohol use were more than four times more likely to be users of smokeless tobacco than nondrinkers. We found increased age, being male, being white, smoking, drinking, perceived effects of smokeless tobacco use, and friends' smoking behavior to be significantly associated with continued use beyond experimentation. Smokeless tobacco use was reportedly greater in rural areas. Adolescents who reported initiating use between 6 and 8 years of age were using on a more frequent basis than those who had initiated use when older. This study demonstrated the need for targeting elementary schools for educational interventions aimed at reducing smokeless tobacco use.

scholarly journals Contemporary Associations of Exclusive Cigarette, Cigar, Pipe, and Smokeless Tobacco Use With Overall and Cause-Specific Mortality in the United States

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Maki Inoue-Choi ◽  
Meredith S Shiels ◽  
Timothy S McNeel ◽  
Barry I Graubard ◽  
Dorothy Hatsukami ◽  
...  
Keyword(s):  
United States ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Hazard Ratios ◽  
Specific Mortality ◽  
Smokeless Tobacco Use ◽  
Overall Mortality

Abstract Background A growing proportion of tobacco users in the United States use non-cigarette products including cigars, pipes, and smokeless tobacco. Studies examining the disease and mortality risks of these products are urgently needed. Methods We harmonized tobacco use data from 165 335 adults in the 1991, 1992, 1998, 2000, 2005, and 2010 National Health Interview Surveys. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall and cause-specific mortality occurring through December 31, 2015, were estimated by exclusive use of cigarettes, cigars, pipes, or smokeless tobacco using Cox proportional hazards regression with age as the underlying time metric and never tobacco users as the referent group. Results Current use of cigarettes (HR = 2.23, 95% CI = 2.13 to 2.33) and smokeless tobacco (HR = 1.36, 95% CI = 1.17 to 1.59) were each associated with overall mortality. Relative to never tobacco users, higher risks were observed both in daily (HR = 2.34, 95% CI = 2.24 to 2.44) and nondaily (HR = 1.69, 95% CI = 1.54 to 1.86) cigarette smokers, with associations also observed across major smoking-related causes of death. Daily use of smokeless tobacco was also associated with overall mortality (HR = 1.41, 95% CI = 1.20 to 1.66) as was daily use of cigars (HR = 1.52, 95% CI = 1.12 to 2.08). Current smokeless tobacco use was associated with a higher risk of mortality from heart disease and smoking-related cancer, with strong associations observed for cancers of the oral cavity and bladder. Conclusions Exclusive daily use of cigarettes, cigars, and smokeless tobacco was associated with higher mortality risk. Tobacco control efforts should include cigars and smokeless tobacco.

Epidemiology of Cancer and Other Systemic Effects Associated with the Use of Smokeless Tobacco

1997 ◽  
Vol 11 (3) ◽  
pp. 313-321 ◽  
Author(s):  
D.M. Winn
Keyword(s):  
Oral Cancer ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Epidemiologic Studies ◽  
The Body ◽  
Cancer Site ◽  
Tobacco Products ◽  
Chewing Tobacco ◽  
Smokeless Tobacco Products ◽  
Smokeless Tobacco Use

Persons who use chewing tobacco and snuff experience an increased risk of oral cancer. Because of the pharmacologic properties of nicotine and other constituents of smokeless tobacco, there is also concern that smokeless tobacco products may lead to cardiovascular diseases as well. The relatively few human population studies to date conflict with respect to whether smokeless tobacco use elevates cardiovascular risk factors or leads to cardiovascular disease or death from cardiovascular causes. Hemoglobin adducts to carcinogens present in smokeless tobacco products are measurable in the blood of smokeless tobacco users, indicating that smokeless-tobacco-related carcinogens circulate throughout the body. This prompts a concern that smokeless tobacco may increase risks of other cancers as well. The evidence to date from epidemiologic studies indicates no relationship between smokeless tobacco and bladder cancer, but there is suggestive evidence linking smokeless tobacco use to prostate cancer risk. Only single studies have been conducted of some cancers, and inconsistencies among studies of the same cancer site have been reported. Molecular epidemiologic studies may help identify markers of malignant transformation in smokeless tobacco users that may help in early intervention to prevent or ameliorate the consequences of oral cancer. Further studies are needed to determine more clearly the cardiovascular and non-oral cancer risks potentially associated with smokeless tobacco use.

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