Table 2.
Details of US studies considered.
| First author, year of publication | Location | Study Perioda | Sex | Age | Population | Further details of study design | Endpointsb |
| Experimental studies | |||||||
| Grasser 1997 [21] | North Carolina | 10 days | M+F | 18 to 47 | 214 soldiers | 4 ST users with oral leukoplakia advised to stop | ML |
| Payne 1998 [22] | Nebraska, Iowa | 7 days | M | Mean 25 | 16 snuff users with oral lesions at habitual sites only | Site of snuff placement changed | ML |
| Martin 1999 [23] | Texas | 6 weeks | M | 17 to 34 | 3051 air force trainees | 119 ST users with oral leukoplakia ordered to stop | ML |
| Prospective studies | |||||||
| Beck 1995 [24] | North Carolina | 1988 to 1991 | M+F | 65+ | 818 dentate adults (50% black, 50% white) | Selected from Piedmont study. Reexamined at 18 and 36 months | PD, OP |
| Dietrich 2007 [25] | National | 1986 to 2002 | M | 40–75 | 43112 health professionals dentate and cancer free at baseline | Data on tooth loss recorded every 2 years | DC |
| Case-control studies | |||||||
| Fisher 2005A [26] | West Virginia | 2001 to 2002 | M+F | 18+ | 90 cases of oral leukoplakia, 78 controls with periapical cysts and no oral leukoplakia | Subjects identified from biopsy of hyperkeratosis | ML |
| Cross-sectional studies of populations unselected by ST use | |||||||
| Greer 1983 [27] | Colorado | Not given | M+F | 14 to 19 | 1119 high school students | - | ML, PD, DC |
| Poulson 1984 [28] | Colorado | Not given | M+F | 14 to 19 Mean 16.7 | 445 high school students | - | ML, PD, DC |
| Offenbacher 1985 [29] | Georgia | Not given | M | 10 to 17 Mean 13.8 | 565 grammar and high school students | - | ML, PD, DC |
| Wolfe 1987 [30] | New Mexico | Not given | M+F | 14 to 19 Mean 16.0 | 226 Native American children at boarding school | - | ML, PD |
| Cummings 1989 [31] | New York | 1985 | M | 22 to 44 Mean 29 | 25 baseball players and coaches | - | ML, PD |
| Creath 1988 [32] | Alabama | Not given | M | 11 to 18 | 995 adolescent football players | - | ML, PD |
| Stewart 1989 [33] | Florida | Not given | M | 10 to 18 | 114 middle and high school students | 5588 M+F interviewed, 182 examined orally, no results for 68F | ML |
| Ernster 1990 [34]c | Arizona | 1988 | M+F | 20 to 29 (77%) | 1109 professional baseball players | - | ML, PD, DC |
| Greene 1992 [35] | Arizona | 1989 to 1990 | M | 20 to 29 (76%) | 894 professional baseball players | - | ML |
| Sinusas 1992 [36] | Pennsylvania | 1990 | M | 17 to 58 Mean 25 | 206 baseball players and managers | - | ML, PD, DC |
| Daughety 1994 [37] | Iowa | Not given | M | 16 to 17 | 821 11th and 12th grade school students | - | ML |
| Robertson 1997 [38] | Arizona | 1988 to 1990 | M | 20 to 29 (77%) | 1846 professional baseball players | Includes subjects in Ernster 1990 [34] and Greene 1992 [35] | ML, PD, DC |
| Tomar 1997 [39]d | National | 1986 to 1987 | M+F | 12 to 17 | 17027 school students | NIDR National Survey of Oral Health | ML |
| Tomar 1999 [40] | National | 1988 to 1994 | M+F | 18+ | 14087 dentate adults | Third National Health and Nutrition Examination Survey (NHANES III) | DC |
| Riley 2004 [41] | Florida | 1993 to 2000 | M+F | 45+ | 873 adults | Reinterviews occurred over a 48 month period but analyses are all cross-sectional | OP |
| Shulman 2004 [42] | National | 1988 to 1994 | M+F | 18+ | 17235 adults | NHANES III, but different endpoints from Tomar 1999 [40] | ML |
| Fisher 2005B [43] | National | 1988 to 1994 | M+F | 18+ | 12932 adults | NHANES III, but different endpoints from Tomar 1999 [40] and Shulman 2004 [42] | PD |
| Sinusas 2006 [44] | Pennsylvania | 1991 to 2000 | M | Mean 26 | 190 to 259 baseball players and coaches examined each year | Men attending spring training. Some men may attend on multiple occasions | ML |
| Cross-sectional studies of populations selected by ST use and/or presence of oral lesions | |||||||
| Smith 1970 [45] | Tennessee | Not given | M+F | Mean 55 | 15000 long-term snuff users | - | ML |
| Christen 1979 [46] | Texas | Not given | M | 18 to 22 Mean 20 | 14 college athletes who used ST | - | ML, PD |
| Kaugars 1992 [47] | Virginia | Not given | M | 14 to 77 Mean 29 | 347 ST users recruited by advertisinge | - | ML |
| Little 1992 [48] | Oregon, Washington | Not given | M | 15 to 77 | 245 ST users in Kaiser Permanente Dental Care Program | Also 223 age-matched non ST users | ML |
| Roberts 1997 [49] | Indiana | 1994 to 1995 | M+F | Not given | 22 snuff users and 19 non users | Oral lesions not recorded in non users | ML |
a Length of follow-up period for experimental studies, period of follow-up for prospective studies, and time study conducted otherwise
b DC = dental caries, ML = mucosal lesion, OP = oral pain, PD = periodontal or gingival diseases
c Similar results are reported by Grady et al [83], Robertson et al [84] and Daniels et al [85]
d Results from this study are also reported by Kleinman et al [86]
e An additional group of 91 non users of ST with no oral lesions provides no useful information and has been ignored