Smokeless tobacco use in adolescent females: prevalence and psychosocial factors among racial/ethnic groups

Prevalence and correlates of lifetime smokeless tobacco use in female military recruits

Although considerable research has been conducted on smokeless tobacco (ST) use in males, much less is known about the characteristics of female ST users. The present study examined the prevalence and correlates of lifetime ST use among female Air Force recruits (N=9,087). Participants were surveyed during Basic Military Training regarding their history of tobacco use and other health risk behaviors. Although the prevalence of current ST use was low (<1%; n=34), 6.6% (n=599) had tried ST. Multivariate logistic regression analysis indicated that lifetime ST use was related to ethnicity, with Native Americans and Whites being most likely to have tried ST. Additional correlates of lifetime ST use included post-high-school education (OR=1.26, 95% CI=1.03-1.55); weekly acts of road rage (OR=1.48, 95% CI=1.06-2.06); frequent arguing (OR=1.71, 95% CI=1.18-2.48); daily or near-daily alcohol consumption (OR=1.71, 95% CI=1.03-2.82); current cigarette use (OR=3.80, 95% CI=2.42-5.94); and experimental use of cigars (OR=4.01, 95% CI=3.22-5.01), pipes (OR=2.23, 95% CI=1.64-3.03), and clove cigarettes (OR=1.23, 95% CI=1.01-1.49), all of which were associated with an increased likelihood of ST use. Results suggest that female recruits who have ever used ST engage in a variety of risk behaviors including use of other tobacco products and alcohol, as well as additional harmful behaviors.

Perceived risks of certain types of cancer and heart disease among Asian American smokers and non-smokers

This study assessed knowledge levels of health risks of tobacco use among the Asian American (AA) community in the Delaware Valley region of Pennsylvania and New Jersey, including metropolitan Philadelphia. A cross-sectional self-report survey was conducted to collect the information, and a stratified-cluster proportional sampling technique was used to obtain a representative sample size of the target population of Chinese, Korean, Vietnamese, and Cambodians. 1374 AA were recruited from 26 randomly selected community organization clusters; of the total recruited, 1174 completed the survey, which consisted of 410 Chinese, 436 Korean, 196 Vietnamese, 100 Cambodian and 32 other-group. Other-group was excluded for this study. Ten questions were asked to determine the knowledge level of the sample population. Results indicated that the vast majority of respondents (82.2%) recognized the association between smoking and increased risk of developing various types of cancers and heart disease. Between 81.3% and 93.3% of respondents recognized the increased risk for lung, mouth, throat.and esophageal cancer and heart disease. For these variables, there were statistically significant differences between the ethnic groups: Koreans were the most knowledgeable, followed by Chinese, Vietnamese, and Cambodians. For bladder, pancreatic, cervical, and kidney cancers, the percentage of respondents indicating an association between these cancers and smoking ranged from 49.2 to 56.8. There were no statistically significant differences among the four ethnic groups for these variables. Generally, however, results showed that the awareness level was higher among women and the more educated respondents, non-smokers and former smokers, and Chinese and Korean groups.

A comparison of male and female smokeless tobacco use

This study explored the factors associated with female smokeless tobacco (ST) use and examined gender differences in factors related to use. Interviews were conducted either in person or by telephone with 51 female and 59 male users from the Pacific Northwest. The interview included both quantitative and qualitative items assessing personal, social, and substance use variables. Male and female users were found to be similar in a variety of areas, such as reasons for initiating use, use of ST in response to different mood states, and high rates of experimentation with other drugs. However, female users reported using ST for weight control more extensively, identified a greater influence by other female users, and reported fewer friends knowing about their use. Male users reported using ST more often during sports activities and in the workplace than did female users, and were almost three times more likely to be highly addicted to ST. The implications of the study for the development of prevention and cessation programs are discussed.

Oral spit tobacco: addiction, prevention and treatment

The prevalence of smokeless tobacco is significant and reaches as high as 17% past month use in white males aged 18-25. Smokeless tobacco use is of concern because of the potential for addiction and the associated negative health consequences. This article reviews the basis for addiction to smokeless tobacco, examining the nicotine content in smokeless tobacco products, pharmacokinetics, psychoactive effects, tolerance, and withdrawal. It also explores the negative health consequences which include a number of oral pathologies and increased cardiovascular risk factors. Furthermore, it examines the factors associated with the initiation of smokeless tobacco use, and the current prevention programs that address these factors. Current smokeless tobacco treatment approaches are also discussed as well as predictors for abstinence. Finally, the future directions are discussed in light of the limited amount of research that has been conducted in the smokeless tobacco area, particularly related to prevention and treatment.

Use of smokeless tobacco by young adult females

In contrast to the well documented use of smokeless tobacco (ST) by men, far less is known about ST use by women. In part this is due to the small overall prevalence of ST use among women (0.6%). This paper is a descriptive report of the use of ST by young adult women in the upper midwest. Twenty women, identified as smokeless tobacco users, completed a tobacco questionnaire and brief interview. The majority (80%) were introduced to ST by friends and 60% had tried cigarettes before using ST. Almost all used ST daily, averaging 3.6 dips per day. The number of dips per day was significantly correlated with salivary cotinine (r = .60). Subjects listed relaxation and pleasure most frequently as reasons for using ST. Twenty-five percent reported using ST to quit smoking and a similar percentage reported using ST to curb their appetite. With the introduction of new flavored snuff products, ST may become more appealing to the tastes of diverse groups including women. The potential acceptance of ST among women should be the focus of further research.

Non-ceremonial tobacco use among southwestern rural American Indians: the New Mexico American Indian Behavioural Risk Factor Survey

OBJECTIVES

To ascertain non-ceremonial tobacco use among rural American Indians in New Mexico (United States).

DESIGN

A geographically targeted telephone survey.

SETTING

Rural New Mexico.

PARTICIPANTS

American Indian residents aged 18 years and older.

MAIN OUTCOME MEASURES

Prevalence of ever-smokers and current smokers of cigarettes and ever-users and current users of smokeless tobacco, number of cigarettes smoked, and prevalence of cigarette smoking quitting behaviour.

RESULTS

Of the 1266 respondents, 38.5% (95% confidence interval (CI) = 34.5% to 42.1%) reported ever smoking, and 16.3% (95% CI = 13.5% to 19.0%) reported being current smokers. Current smokers averaged 7.6 (95% CI = 6.0 to 9.3) cigarettes per day. Current smoking prevalence was highest among men and lowest among college graduates. Prevalence of smokeless tobacco use was 24.1% for ever-use and 7.2% for current use and showed a strong male predominance of use.

CONCLUSIONS

The prevalence of current smokers among rural American Indians in New Mexico was lower than among American Indians of other regions in the United States, all New Mexicans, and the national population as a whole. Although smoking prevalence was lower among American Indians in New Mexico, variation by sex and education followed the same patterns as reported among American Indians of other regions.

Eating behavior and weight control among women using smokeless tobacco, cigarettes, and normal controls

Although considerable research has investigated the use of cigarette smoking for weight management, the potential role of smokeless tobacco (ST) use in dieting behavior has not been explored. Several measures designed to assess dieting behavior, attitudes toward eating, and tobacco use were administered to adult women using ST (n = 18), cigarettes (n = 20), and no tobacco (n = 20). Use of tobacco for weight loss was prevalent among the women smoking cigarettes. Nearly half the women in the cigarette-smoking group (45%) reported use of cigarettes to assist in weight loss, and only three (16.6%) of the women in the ST groups indicated use of ST for such purposes. No significant differences were observed across groups on measures of dietary restraint or attitudes toward eating. Issues of dieting and weight control may not be important factors in prompting ST use. Implications and areas for further research are discussed.

Behavioral effects of smokeless tobacco on the neonate and young Sprague Dawley rat

Three dosages of Smokeless Tobacco (ST) extract were given to pregnant Sprague-Dawley rats by oral gavage on gestational days (GD) 6-20. The three dosages contained ST extract equivalent to 1.33 mg/kg nicotine (STD-1), 4.0 mg/kg nicotine (STD-2), and 6.0 mg/kg nicotine (STD-3). Dams were intubated three times per day at 8 a.m., 11 a.m., and 2 p.m., providing total daily ST dosages of 4 mg/kg, 12 mg/kg, and 18 mg/kg, respectively. Controls received equivalent volumes of water by gavage. Dams were allowed to deliver, and all biological mothers raised their own pups. On postnatal day 1 (PND 1), litters were culled to 4 +/- 1 females and 4 +/- 1 males. Weights, physical landmark development, and behavioral performance of pups were monitored during pre- and post-weaning periods. Behavioral tests included surface righting, negative geotaxis, swimming development, open field activity, and active avoidance in shuttle box. Our results show that the two higher doses resulted in reduced maternal weight gain. During the pre-weaning period, significant pup weight reductions were noted in the STD-2 pups until PND6, and in the STD-3 group until PND15. In the STD-1 group no statistically significant weight reduction was noted on PNDs 1 and 3, but starting with PND6, pup weights surpassed control group weights. This weight difference persisted throughout the post-weaning period also (P < .05 on PND30 and PND42). The STD-3 pup weights continued to be consistently and significantly (P < .05) reduced throughout the post-weaning period (except on PND24); likewise, the STD-2 pups continued to have lower weights, but at a significant level (P < .05) on PND30 only. The incidence of deaths was increased in a dose-related manner. No significant differences were noted for pinna detachment and incisor eruption; however ST-treatment was significant in affecting earlier eye opening and vaginal patency. N significant ST treatment effects were seen on negative geotaxis, but for surface righting a decreased success rate was noted for the ST-treated groups. Significant differences were noted in swimming development, with the STD-2 pups performing best. Open field activity, as expected, increased from the pre-weaning to post-weaning periods. During the pre-weaning period the STD-3 pups were more active, and during post-weaning the STD-1 pups were more active, but no differences were noted in vertical activity or in the number of stereotypical movements. No treatment-related differences were noted in the active avoidance shuttle box.(ABSTRACT TRUNCATED AT 400 WORDS)

Situational factors and patterns associated with smokeless tobacco use

Situational factors and topographic features associated with smokeless tobacco use were examined. Male smokeless tobacco users (N = 30) were asked to record the time, activity, and internal states associated with each dip of tobacco use over the course of 10 days. Additionally, these subjects were asked to record the activity and internal state they were experiencing every hour for a 15-hr waking period to obtain baseline rates of these events. Serum and saliva samples were obtained to measure cotinine concentrations. The activities significantly associated with smokeless tobacco use included after a meal, while driving, and while watching television. The internal states associated with smokeless tobacco use were feeling relaxed and depressed. Factor analysis of the events showed factors which are different from those found among cigarette smokers. Examination of the topographic measures of smokeless tobacco use showed that the total dip duration per day was 283.5 min, with a range of 79.7-757.1 min. This measure, along with duration of dipping time (time from onset to offset of smokeless tobacco use during the day), may be the best predictors of nicotine exposure.

The role of race and ethnic status on the psychosocial correlates of smokeless tobacco use in adolescent males

From a stratified, random sampling of non-urban high schools in the Southeast, survey data were obtained from 5374 adolescent males. Over half reported trying smokeless tobacco, and approximately one third of these reported a regular, substantial level of use. The average age at initial use was 12.2 yr. and was negatively correlated with the level of use. Factor analysis of the psychosocial items resulted in four factors: substance use/deviant style, modeling, perceived negative consequences, and health behavior. Discriminant analysis of initial use indicated that substance use and modeling influences were the strongest predictors of trying smokeless tobacco. Regression analysis of level of smokeless tobacco use indicated that substance use, modeling, and perceived negative consequences were equivalent in their contribution. Separate analyses were performed for American Indian, Black, and White males. Although predictors of initial use were similar, level of smokeless tobacco use was most associated with the use of other substances in Blacks and with modeling influences in Whites.