Evidence That Smokeless Tobacco Use Is a Gateway for Smoking Initiation in Young Adult Males

Haddock, C. Keith; Weg, Mark W. Vander; DeBon, Margaret; Klesges, Robert C.; Talcott, G. Wayne; Lando, Harry A.; Peterson, Alan L.

doi:10.1006/pmed.2000.0802

Cited by 125 publications

(121 citation statements)

References 17 publications

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“…[33][34] Tobacco in the form of Swedish moist oral snuff (snus) is today highly prevalent in the Swedish male population, and has been increasing during the past decades from 22% to 30%. 35 The proposal that usage of smokeless tobacco might lead to smoking behavior [36][37] has been of major concern, however some results suggest snuff dipping to be more closely related to cessation of smoking (i.e. ex-smokers become snuff dippers).…”

Section: Discussionmentioning

confidence: 99%

Tobacco use, body mass index and the risk of malignantlymphomas—A nationwide cohort study in Sweden

Fernberg

Odenbro

Bellocco

et al. 2005

Intl Journal of Cancer

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In the search for risk factors involved in the etiology of lymphoproliferative malignancies there is still inconsistent evidence regarding effects of smoking tobacco, and the role of smokeless tobacco is poorly investigated. New evidence indicates that excess body weight increases the risk of NHL and HD. To determine if tobacco use of various forms and high Body Mass Index (BMI) affect the occurrence of these neoplasms, we conducted a prospective cohort study on over 330,000 Swedish construction workers included in the Construction Industry Working Environment and Health program. Information on smoking, snuff dipping, height and weight was gathered by self administered questionnaires together with personal interviews. Cancer incidence was ascertained through the year 2000 by record linkage to the nationwide Swedish Cancer Registry, Migration Registry and Cause of Death Registry. At the end of follow up, 1,309 subjects had been diagnosed with NHL (including chronic lymphocytic leukemia) and 205 with HD respectively. Age adjusted incidence rate ratios were computed using Cox proportional Hazard regression modeling. Smoking cigarette, pipe or cigar was not associated with NHL or HD. There was no evidence indicating a relation between quantity and duration of smoking and NHL or HD risk. No link was found between NHL and usage of smokeless tobacco. Having a BMI of 30 or higher did not convey excess risk of developing NHL or HD compared to normal weight ). We conclude that tobacco smoking and high BMI do not entail an increased risk of NHL and HD. Our findings of a relation between the duration of snuff dipping and HD need further investigation. ' 2005 Wiley-Liss, Inc.Key words: non-Hodgkin's lymphoma; Hodgkins disease; smokingtobacco; moist snuff; body mass index Over the past decades, there has been controversy regarding the impact of tobacco use on the development of lymphatic malignancies. Although studies conducted within this area are not sparse, results have been largely inconsistent. In part, the conflicting results might reflect the various designs and sizes of the studies, study type and subjects, interview compliance and if information was obtained from study subjects or their next of kin.Tobacco smoke is known to comprise a number of components, including benzene, lead and polonium 1-3 affecting the immune system by means such as increasing mean leukocyte counts, [4][5] most strongly correlated to neutrophils and CD41 cells, 5 and altered T-cell function. 6 Moreover smoking has been correlated to lowered levels of immunoglobulins, lysozyme as well as a decrease in the total number of NK-cells in long time smokers. 7Whereas several studies have suggested smoking to be associated with NHL [8][9][10][11]8,12 others have failed to confirm these results. [13][14][15][16][17][18][19] More recent studies have indicated this relation to be particularly strong for follicular lymphoma and high grade lymphomas. 9,17,20 Overweight and obesity has become a globally accelerating health issue related to increased morbidi...

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Section: Discussionmentioning

confidence: 99%

Tobacco use, body mass index and the risk of malignantlymphomas—A nationwide cohort study in Sweden

Fernberg

Odenbro

Bellocco

et al. 2005

Intl Journal of Cancer

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“…1,134 Data from 2 studies have shown that young nonsmoking men who were ST product users were 2 to 3 times more likely to become active cigarette smokers. 138,139 However, data from other studies have shown little relationship between ST product use and smoking initiation 140 or that associations could be explained by confounding psychosocial factors. 141,142 There is concern that youth and young people may be lulled into a false sense of security by turning to PREPs or ST products.…”

Section: The Role Of Social Norms and Preps For Cigarette Smoking Cesmentioning

confidence: 99%

Impact of Smokeless Tobacco Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment

Benowitz²,

et al. 2010

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on behalf of the American Heart Association Council on Cardiovascular Nursing V arious forms of smokeless tobacco (ST) products (snuff, chewing tobacco) are used by individuals of all ages. Over the past several years, US tobacco companies have expanded marketing and promotion of ST products. A major aim of this statement is to review and summarize the scientific evidence regarding ST product use and the potential cardiovascular risks associated with ST product use that can be used to inform policy related to tobacco control and strategies related to tobacco harm reduction. A specific policy question is whether ST products should be recommended to smokers instead of cigarettes to reduce the morbidity and mortality associated with smoking and/or as an approach to enhance smoking cessation. Although evidence is consistent with the suggestion that the cardiovascular risks are lower with ST products compared with cigarette smoking, ST products are not without harm. As reviewed in this statement, there is evidence that long-term ST product use may be associated with a modest risk of fatal myocardial infarction (MI) and fatal stroke, suggesting that ST product use may complicate or reduce the chance for survival after a MI or stroke. In addition, there is inadequate evidence to support the use of ST products as a smoking cessation strategy. Based on the findings reviewed in this statement, clinicians should continue to discourage use of all tobacco products and emphasize prevention of smoking initiation and smoking cessation as primary goals for tobacco control.In the United States, various forms of ST products (snuff, chewing tobacco) are used by individuals of all ages, including adolescents and young adults.

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“…ST use has also been associated with oral and extra-oral cancer (Goodman, Morgenstern, & Wynder, 1986;Henley, Thun, Connell, & Calle, 2005;Muscat, Hoffmann, & Wynder, 1995;Stockwell & Lyman, 1986) as well as cardiovascular and cerebrovascular disease (Henley et al, 2005;Teo et al, 2006). Evidence also suggests that smokeless tobacco may be a gateway drug for smoking initiation in adolescent and young adult males (Haddock et al, 2001;Severson, Forester, & Biglan, in press;Tomar, 2003a), although conflicting results have been reported in other studies (O'Connor, Kozlowski, Flaherty, & Edwards, 2005).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of alternative forms of tobacco use in a population of young adult military recruits

Weg

Peterson

Ebbert

et al. 2008

Addictive Behaviors

Self Cite

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Recent evidence suggests that the popularity of certain alternative forms of tobacco may be increasing in adolescents. Little is known, however, about the use of these products among young adults. This study examined the use of alternative tobacco products including bidis, cigars, kreteks (clove cigarettes), pipes, and smokeless tobacco in a large sample of young adult military recruits (N=31107). Overall, 18.5% of participants were using some form of alternative tobacco product prior to entry into Basic Military Training. Results revealed a relatively high prevalence of cigar (12.3%) and smokeless tobacco use (6.7%). Use of other products was less common, including 1.1% for pipes, 2.0% for bidis, and 3.0% for kreteks. With the exception of kreteks, which did not differ by gender, the prevalence of use of alternative tobacco products was greater for males than for females ( p<. 001). Patterns of use also differed according to other demographic characteristics including race, ethnicity, age, and income. Implications for surveillance and tobacco control efforts are discussed.

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Evidence That Smokeless Tobacco Use Is a Gateway for Smoking Initiation in Young Adult Males

Cited by 125 publications

References 17 publications

Tobacco use, body mass index and the risk of malignantlymphomas—A nationwide cohort study in Sweden

Tobacco use, body mass index and the risk of malignantlymphomas—A nationwide cohort study in Sweden

Impact of Smokeless Tobacco Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment

Prevalence of alternative forms of tobacco use in a population of young adult military recruits

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