Concurrent Use of Cigarettes and Smokeless Tobacco among US Males and Females

Abstract

Background. The current study describes concurrent use of cigarettes and smokeless tobacco (CiST) among males and females and evaluates factors associated with CiST use. Methods. Cross-sectional data were drawn from the 2010 Behavioral Risk Factor Surveillance System (BRFSS). Weighted stratified analyses were performed to find associations between CiST use and sociodemographic factors by gender. CiST users were compared to three different tobacco use groups: nonusers, exclusive smokers, and exclusive ST users. Results. Younger age and heavy alcohol consumption were consistently associated with increased odds of CiST use among both males and females, and regardless of comparison group. Among males, education was inversely related to CiST use, and these findings were consistent in all three comparisons. Among women, those unable to work or out of work were more likely to be CiST users, which was consistent across comparisons. American Indian females had higher odds of CiST use than White females when nontobacco users or smokers were the comparison group. Conclusion. This study identified sociodemographic characteristics associated with CiST use, and differences in these associations among women and men. Additionally, this study highlights the need to carefully consider what comparison groups should be used to examine factors associated with CiST use.

Polytobacco Use of Cigarettes, Cigars, Chewing Tobacco, and Snuff Among US Adults

“…To compare our results with the literature of poly-use among current tobacco users, 13,16,[29][30][31][32][34][35][36][37][38][39] it is worth pointing out that previous poly-use prevalence estimates varied widely depending on types of tobacco products examined, frequency of tobacco use (daily vs. nondaily), and gender. In the literature, dual use of cigarettes with SLT (chewing tobacco and snuff) 16,30,31,35,36 and dual use of cigarettes with snuff 13,37 were the most commonly examined poly-use combinations.…”

“…At the population level, some studies estimated the prevalence of current polytobacco use among special populations such as the Lumbee American Indians in North Carolina (4.8%), 22 Air Force recruits (1.3%−3.3%), 5,23 active duty military personnel (11.5%), 24 college students (7.4%), 25 young adults aged 18−34 (7.0%), 26 and cancer prevention trial participants (3.7%), 27 while others estimated the prevalence of current polytobacco use among the general population of all adults (ranging from 0.3%−1.6% [28][29][30][31] to 2.5%−3.4% 32,33 and up to 10.6% 34 ), of all men (0.6%−1.6%), 28,[35][36][37] and of all women (0.3%). 36 At the tobacco users' level, the vast majority of studies estimated the prevalence of current polytobacco use among current cigarette smokers (ranging from 2.3%−8.5% 13 , and relatively few studies estimated the prevalence of current polytobacco use among current users of all tobacco products combined (9.9%−12.1% of those aged ≥26 and 21.4%−24.6% of those aged 18−25), 39 among male current snuff users (15.0%−19.2% of daily snuff users and 38.9%−44.7% of nondaily snuff users), 13,37 and among current SLT users (25.0%−42.4%). 30,31,35,36 There is a lack of studies that examine polytobacco use among current cigar users, even though it has been shown that cigars were the most prevalent product concurrently used among current cigarette smokers, 29 and one-half of all polytobacco users consumed both cigarettes and cigars.…”

“…36 At the tobacco users' level, the vast majority of studies estimated the prevalence of current polytobacco use among current cigarette smokers (ranging from 2.3%−8.5% 13 , and relatively few studies estimated the prevalence of current polytobacco use among current users of all tobacco products combined (9.9%−12.1% of those aged ≥26 and 21.4%−24.6% of those aged 18−25), 39 among male current snuff users (15.0%−19.2% of daily snuff users and 38.9%−44.7% of nondaily snuff users), 13,37 and among current SLT users (25.0%−42.4%). 30,31,35,36 There is a lack of studies that examine polytobacco use among current cigar users, even though it has been shown that cigars were the most prevalent product concurrently used among current cigarette smokers, 29 and one-half of all polytobacco users consumed both cigarettes and cigars. 3 Given the increasing use of non-cigarette tobacco products, the popularity of polytobacco use, and the limited research examining polytobacco use among non-cigarette tobacco users, this study aims to assess the prevalence, trends, and correlates of polytobacco use separately among current cigarette smokers as well as three groups of non-cigarette tobacco users-current cigar users, current chewing tobacco users, and current snuff users-using a large-scale nationally representative survey of the US adult population.…”

“…Alcohol drinking has been identified as an important risk factor for tobacco use 23,40 and polytobacco use 5,23,27,36 ; therefore, we included binge drinking as a covariate. Respondents who have had at least 12 drinks of any type of alcoholic beverage in their lifetime and who answered "at least one day" to the NHIS question: "In the past year, on how many days did you have 5 or more drinks of any alcoholic beverage?"…”

High tobacco use prevalence with significant regional and sex differences in smokeless tobacco use among Western Alaska Native people: the WATCH study

“…That study focused only on current tobacco users in the Bristol Bay region, and did not differentiate between commercial ST and iqmik . Recent US studies demonstrate that dual- or multi-product use is most prevalent among young adults [16,20,45]. While these studies report up to 30% of young adults are dual product users [19], this percentage is far lower than in AN residents of the Y-K region.…”