Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1998 Jan;88(1):20–26. doi: 10.2105/ajph.88.1.20

Incidence and predictors of smokeless tobacco use among US youth.

S L Tomar 1, G A Giovino 1
PMCID: PMC1508391  PMID: 9584028

Abstract

OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of initiation of smokeless tobacco use in a cohort of young persons and to explore sociodemographic, environmental, behavioral, and personal predictors of experimentation with and regular use of snuff or chewing tobacco. METHODS: The data for this cohort study were derived from the 1989 Teenage Attitudes and Practices Survey and its 1993 follow-up. The study included 7830 young people 11 through 19 years of age at baseline. RESULTS: During the 4 years, 12.7% of participants (20.9% of male participants) first tried smokeless tobacco, and 4.0% (8.0% of male participants) became self-classified regular users. This suggests that, each year, approximately 824000 young people in the United States 11 to 19 years of age experiment with smokeless tobacco and about 304 000 become regular users. Cumulative incidence was highest for male non-Hispanic Whites. Predictors of regular use included age, geographic region, cigarette smoking, participation in organized sports, and perceived friends' approval or indifference. CONCLUSIONS: Public health approaches to preventing use of smokeless tobacco should include development of skills for responding to pressures to use tobacco.

Full text

PDF
20

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ary D. V., Lichtenstein E., Severson H. H. Smokeless tobacco use among male adolescents: patterns, correlates, predictors, and the use of other drugs. Prev Med. 1987 May;16(3):385–401. doi: 10.1016/0091-7435(87)90039-9. [DOI] [PubMed] [Google Scholar]
  2. Ary D. V. Use of smokeless tobacco among male adolescents: concurrent and prospective relationships. NCI Monogr. 1989;(8):49–55. [PubMed] [Google Scholar]
  3. Bauman K. E., Koch G. G., Bryan E. S., Haley N. J., Downton M. I., Orlandi M. A. On the measurement of tobacco use by adolescents. Validity of self-reports of smokeless tobacco use and validity of cotinine as an indicator of cigarette smoking. Am J Epidemiol. 1989 Aug;130(2):327–337. doi: 10.1093/oxfordjournals.aje.a115339. [DOI] [PubMed] [Google Scholar]
  4. Bauman K. E., Koch G. G., Lentz G. M. Parent characteristics, perceived health risk, and smokeless tobacco use among white adolescent males. NCI Monogr. 1989;(8):43–48. [PubMed] [Google Scholar]
  5. Bolinder G., Alfredsson L., Englund A., de Faire U. Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers. Am J Public Health. 1994 Mar;84(3):399–404. doi: 10.2105/ajph.84.3.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Botvin G. J., Baker E., Tortu S., Dusenbury L., Gessula J. Smokeless tobacco use among adolescents: correlates and concurrent predictors. J Dev Behav Pediatr. 1989 Aug;10(4):181–186. [PubMed] [Google Scholar]
  7. Brownson R. C., DiLorenzo T. M., Van Tuinen M. Smokeless tobacco use among Missouri youth. Mo Med. 1990 Jun;87(6):351–354. [PubMed] [Google Scholar]
  8. Bruerd B. Smokeless tobacco use among Native American school children. Public Health Rep. 1990 Mar-Apr;105(2):196–201. [PMC free article] [PubMed] [Google Scholar]
  9. Castro F. G., Maddahian E., Newcomb M. D., Bentler P. M. A multivariate model of the determinants of cigarette smoking among adolescents. J Health Soc Behav. 1987 Sep;28(3):273–289. [PubMed] [Google Scholar]
  10. Cohen R. Y., Sattler J., Felix M. R., Brownell K. D. Experimentation with smokeless tobacco and cigarettes by children and adolescents: relationship to beliefs, peer use, and parental use. Am J Public Health. 1987 Nov;77(11):1454–1456. doi: 10.2105/ajph.77.11.1454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Colborn J. W., Cummings K. M., Michalek A. M. Correlates of adolescents' use of smokeless tobacco. Health Educ Q. 1989 Spring;16(1):91–100. doi: 10.1177/109019818901600110. [DOI] [PubMed] [Google Scholar]
  12. Connolly G. N., Orleans C. T., Blum A. Snuffing tobacco out of sport. Am J Public Health. 1992 Mar;82(3):351–353. doi: 10.2105/ajph.82.3.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Dent C. W., Sussman S., Johnson C. A., Hansen W. B., Flay B. R. Adolescent smokeless tobacco incidence: relations with other drugs and psychosocial variables. Prev Med. 1987 May;16(3):422–431. doi: 10.1016/0091-7435(87)90041-7. [DOI] [PubMed] [Google Scholar]
  14. Ernster V. L. Advertising and promotion of smokeless tobacco products. NCI Monogr. 1989;(8):87–94. [PubMed] [Google Scholar]
  15. Escobedo L. G., Marcus S. E., Holtzman D., Giovino G. A. Sports participation, age at smoking initiation, and the risk of smoking among US high school students. JAMA. 1993 Mar 17;269(11):1391–1395. [PubMed] [Google Scholar]
  16. Giovino G. A., Schooley M. W., Zhu B. P., Chrismon J. H., Tomar S. L., Peddicord J. P., Merritt R. K., Husten C. G., Eriksen M. P. Surveillance for selected tobacco-use behaviors--United States, 1900-1994. MMWR CDC Surveill Summ. 1994 Nov 18;43(3):1–43. [PubMed] [Google Scholar]
  17. Glover E. D., Laflin M., Flannery D., Albritton D. L. Smokeless tobacco use among American college students. J Am Coll Health. 1989 Sep;38(2):81–85. doi: 10.1080/07448481.1989.9938420. [DOI] [PubMed] [Google Scholar]
  18. Hall R. L., Dexter D. Smokeless tobacco use and attitudes toward smokeless tobacco among Native Americans and other adolescents in the northwest. Am J Public Health. 1988 Dec;78(12):1586–1588. doi: 10.2105/ajph.78.12.1586. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Jones R. B., Moberg D. P. Correlates of smokeless tobacco use in a male adolescent population. Am J Public Health. 1988 Jan;78(1):61–63. doi: 10.2105/ajph.78.1.61. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kessler D. A., Witt A. M., Barnett P. S., Zeller M. R., Natanblut S. L., Wilkenfeld J. P., Lorraine C. C., Thompson L. J., Schultz W. B. The Food and Drug Administration's regulation of tobacco products. N Engl J Med. 1996 Sep 26;335(13):988–994. doi: 10.1056/NEJM199609263351321. [DOI] [PubMed] [Google Scholar]
  21. Leopardi E. A., Poulson T. C., Neiger B. L., Lindenmuth J. E., Greer R. O., Jr A report of two smokeless tobacco surveys and associated intervention strategies among Utah adolescents. J Cancer Educ. 1989;4(2):125–134. doi: 10.1080/08858198909527986. [DOI] [PubMed] [Google Scholar]
  22. Lucas B. K., Christen A. G. The prevalence, attitudes and perceptions of smokeless tobacco use by 5th, 8th and 11th grade urban boys in central Indiana. J Indiana Dent Assoc. 1988 May-Jun;67(3):9–15. [PubMed] [Google Scholar]
  23. Murray D. M., Roche L. M., Goldman A. I., Whitbeck J. Smokeless tobacco use among ninth graders in a north-central metropolitan population: cross-sectional and prospective associations with age, gender, race, family structure, and other drug use. Prev Med. 1988 Jul;17(4):449–460. doi: 10.1016/0091-7435(88)90044-8. [DOI] [PubMed] [Google Scholar]
  24. Riley W. T., Barenie J. T., Myers D. R. Typology and correlates of smokeless tobacco use. J Adolesc Health Care. 1989 Sep;10(5):357–362. doi: 10.1016/0197-0070(89)90211-8. [DOI] [PubMed] [Google Scholar]
  25. Schinke S. P., Schilling R. F., 2nd, Gilchrist L. D., Ashby M. R., Kitajima E. Native youth and smokeless tobacco: prevalence rates, gender differences, and descriptive characteristics. NCI Monogr. 1989;(8):39–42. [PubMed] [Google Scholar]
  26. Sussman S., Dent C. W., Stacy A. W., Sun P., Craig S., Simon T. R., Burton D., Flay B. R. Project towards no tobacco use: 1-year behavior outcomes. Am J Public Health. 1993 Sep;83(9):1245–1250. doi: 10.2105/ajph.83.9.1245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Sussman S., Holt L., Dent C. W., Flay B. R., Graham J. W., Hansen W. B., Johnson C. A. Activity involvement, risk-taking, demographic variables, and other drug use: prediction of trying smokeless tobacco. NCI Monogr. 1989;(8):57–62. [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES