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 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.

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.

scholarly journals Are cohort data on smokeless tobacco use and pancreatic cancer confounded by alcohol use?

2011 ◽  
Vol 22 (8) ◽  
pp. 1930-1931 ◽  
Author(s):  
O. Nyrén ◽  
M. Lambe ◽  
W. Ye ◽  
H.-O. Adami
Keyword(s):  
Pancreatic Cancer ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Cohort Data ◽  
Smokeless Tobacco Use

Dual Burden of Smoked and Smokeless Tobacco Use in India, 2009–2017: A Repeated Cross-Sectional Analysis Based on Global Adult Tobacco Survey

2020 ◽  
Vol 22 (12) ◽  
pp. 2196-2202 ◽  
Author(s):  
Prashant Kumar Singh ◽  
Amit Yadav ◽  
Pranay Lal ◽  
Dhirendra N Sinha ◽  
Prakash C Gupta ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Public Awareness ◽  
Intention To Quit ◽  
Dual Use ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Dual Burden

Abstract Introduction The dual use of smoked and smokeless tobacco (SLT) poses a serious challenge to tobacco control efforts. This article examines the trends and patterns of this usage in India during the period 2009–2010 and 2016–2017. Methods Data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009–2010 and 2016–2017 have been used. Dual use was assessed based on current smokers and SLT users in both rounds. Results Findings reveal that dual use in India has dropped from 5.3% during 2009–2010 to 3.4% during 2016–2017, a decline of nearly 10 million dual users. However, some states have added nearly 4.6 million new dual users during this period. While dual use continues to remain high in rural areas, there has been a manifold increase in urban areas. Findings revealed that intention to quit tobacco was lower among dual tobacco users as compared to single users with considerable difference between urban and rural areas. Conclusion Easy availability and affordability of SLT products compared to smoking products and restrictions on smoking in public places may have pushed current smokers and dual users to take to or intensify their SLT consumption. Measures relating to awareness, pricing, taxation, and enforcement of tobacco control laws should focus on all forms of tobacco, especially targeting high dual burden in rural and urban settings. Implications Dual form of tobacco users represent 12% of all tobacco users in the country. The study reveals that intention to quit tobacco among dual users is significantly lower than that among single tobacco product users. This requires improving public awareness about the morbidity and mortality that arises from the use of all forms of tobacco products. Efforts to restrict the availability of tobacco products should focus on licensing the sale of all tobacco products. Reduction in dual tobacco use will not only result in multiplied health benefits but also help in achieving the Non-Communicable Diseases targets under the United Nations Sustainable Development Goals.

scholarly journals Smoke-Free Ordinances and Policies Protect Youth, but Ordinances Appear to Have Little Impact on Non-Combustible Tobacco Use

Children ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. 44
Author(s):  
Nell Valentine ◽  
Emily McClelland ◽  
Robert McMillen
Keyword(s):  
High School Students ◽  
Cigarette Smoking ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Cigarette Use ◽  
Lower Prevalence ◽  
Tobacco Products ◽  
Shs Exposure ◽  
Smokeless Tobacco Use ◽  
Cigar Smoking

Smoke-free ordinances and policies protect youth from exposure to secondhand smoke (SHS) and cigarette use. This study investigated whether smoke-free ordinances also protect youth from the use of other tobacco products. We compared the prevalence of SHS exposure, cigarette smoking, cigar smoking, smokeless tobacco use, and e-cigarette use among high school students living in a municipality with or without a smoke-free ordinance and in homes with and without smoke-free policies. Data were analyzed using the 2017 Mississippi Youth Tobacco Survey (n = 1923). Smoke-free ordinances were found to be associated with lower prevalence of SHS exposure (41.9% vs. 51.5%), cigarette smoking (5.1% vs. 11.4%), and cigar smoking (7.2% vs. 10.9%). There were no differences in smokeless tobacco use (6.6% vs. 6.5%) or e-cigarette use (11.2% vs 12.1%). Smoke-free homes were associated with lower prevalence of SHS exposure (38.0% vs 74.6%), cigarette smoking (4.8% vs. 17.6%), cigar smoking (6.4% vs. 16.4%), smokeless tobacco use (4.9% vs. 13.2%), and e-cigarette use (9.6% vs. 19.5%), p < 0.05 for all comparisons. The results suggest that smoke-free ordinances and policies protect against exposure to tobacco smoke and use of combustible tobacco products, but smoke-free ordinances do not protect from smokeless tobacco and e-cigarette use. Tobacco-free, rather than smoke-free, ordinances might offer more protection.

scholarly journals Factors Associated with Smokeless Tobacco Use among Pregnant Women in Rural Areas of the Southern Terai, Nepal

2017 ◽  
Vol 15 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Jitendra Kumar Singh ◽  
Dilaram Acharya ◽  
Rajendra Kadel ◽  
Samaj Adhikari ◽  
Daniel Lombard ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Pregnant Women ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Smokeless Tobacco Use ◽  
Pregnant Mothers

Background: Tobacco use among women during pregnancy leading to poor maternal and child health outcomes has been well documented. However, factors influencing use of smokeless tobacco in Nepal has not yet been well established. This study aims at exploring the factors related to smokeless tobacco use among pregnant women in rural southern Terai of Nepal.Methods: A community-based cross-sectional study was performed at 52 wards within 6 Village Development Committee in Dhanusha district of Nepal. A total of 426 expectant mothers in their second trimester were selected using a multistage cluster sampling method. Descriptive and regression analyses were done to explore the factors that influence smokeless tobacco use.Results: In a total of 426 pregnant mothers, one in five used tobacco in any form. Among the users, 13.4% used smokeless tobacco. Pregnant mothers who were smoking tobacco (AOR 6.01; 95% CI (1.88-19.23), having alcohol consumption (AOR 3.86; 95% CI (1.23-12.08), stressed (AOR 5.04; 95% CI (1.81-14.03), non-vegetarian (AOR 3.31;(1.84-13.03), not attending regular mothers’ group meetings (AOR 4.63; (1.41-15.19), and not-exposed to mass media (AOR 5.02; (1.89-13.33) were significantly associated with smokeless tobacco use. Similarly, mothers of age group 20-34 years, dalit, aadibasi and janajati, hill origin, no education and primary education were more likely to use smokeless tobacco than their counterparts.Conclusions: Factors such as smoking tobacco, alcohol consumption, stress, and poor education were found to be significantly associated with smokeless tobacco use among pregnant women in southern Terai of Nepal. This requires an immediate attention develop an effective strategy to prevent and control smokeless tobacco use among pregnant women in southern Terai of Nepal.

Prevalence and Patterns of Smokeless Tobacco Use in a Southeastern University

1987 ◽  
Vol 17 (3) ◽  
pp. 201-211 ◽  
Author(s):  
Elbert D. Glover ◽  
Elizabeth W. Edmundson ◽  
Paul P. Alston ◽  
Don Holbert ◽  
Kathleen L. Schroeder
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Southeastern United States ◽  
Female Students ◽  
Male Students ◽  
Education Programs ◽  
Tobacco Products ◽  
Adverse Health Effects ◽  
Patterns Of Use ◽  
Smokeless Tobacco Use

The purpose of this study was to determine prevalence and patterns of use for tobacco products, especially, the use of smokeless tobacco among students at a university in the Southeastern United States. Six-hundred and thirty-two students, representing both sexes, participated in the survey, which elicited information regarding current and former use of tobacco products. Smokeless tobacco use was considerably more prevalent among male students than among female students; the reverse was true for cigarette smoking. Overall, the prevalence of tobacco use in this study indicates a need to begin health education programs regarding the adverse health effects of smokeless tobacco use with males and to revise smoking education programs to place more emphasis on female usage.

“Country Boys Spit and Dip”: Masculinity and Rural Adolescent Smokeless Tobacco Use

2020 ◽  
pp. 106082652094645
Author(s):  
Donald W. Helme ◽  
Edward Morris ◽  
Ana de la Serna ◽  
Carina Zelaya ◽  
Carrie Oser ◽  
...  
Keyword(s):  
High School ◽  
High School Students ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Health Research ◽  
School Students ◽  
Rural High School ◽  
Smokeless Tobacco Use ◽  
Rural Adolescent

While tobacco use nationwide is declining, smokeless tobacco (SLT) use remains steady, particularly among men in rural areas. Despite the harms of SLT, researchers know little about what initiates and sustains this use. In this study, we argue that SLT persistence is encouraged by its salience as an emblem of rural manhood. Based on interviews with 64 male and 19 female rural high school students we find that SLT symbolizes rural masculinity, and that many boys “spit and dip” to perform their status as rural men. We specify several peer, family, and community mechanisms that undergird this process. Finally, we discuss implications for men’s health research and intervention efforts.

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