Smokeless Tobacco Use in the United States: Health Implications and Policy Options

1988 ◽  
Vol 9 (4) ◽  
pp. 485 ◽  
Author(s):  
Cathy L. Backinger ◽  
Stephen B. Corbin ◽  
Lawrence J. Furman
Keyword(s):  
United States ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
The United States ◽  
Policy Options ◽  
Health Implications ◽  
Smokeless Tobacco Use

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

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.

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.

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