Patterns of dual use of cigarettes and smokeless tobacco among US males: findings from national surveys

Abstract

BackgroundIn the USA, consumption of moist snuff continues to increase and cigarette manufacturers now control nearly its entire market. Manufacturers have developed new products that represent cigarette brand extension and in test marketing are promoting dual use of cigarettes and snuff. This study examined patterns of concurrent use of smokeless tobacco (ST) and cigarettes among young people and adults in the USA just before cigarette companies' control of the nation's ST market.MethodsData were drawn from four US nationally representative surveys. Stratified analyses applied sampling weights and accounted for the complex sample designs.ResultsCigarette smoking was substantially more prevalent among young males who used ST than among those who did not. Among adult males, those who smoked daily were less likely than others to have used snuff every day. Men who used moist snuff daily had the lowest prevalence of daily smoking, but the prevalence of daily smoking was relatively high among men who used moist snuff less than daily. Unsuccessful past-year attempts by daily smokers to quit smoking were more prevalent among non-daily snuff users (41.2%) than among those who had never used snuff (29.6%).ConclusionsAlthough dual daily use of ST and cigarettes is relatively uncommon in the USA, concurrent ST use is more common among adolescent and young adult male smokers than among more mature tobacco users. Among adult males, daily smoking predominates and non-daily ST use is very strongly associated with current smoking. Adult male smokers who also use ST daily tend to have relatively high levels of serum cotinine and high prevalence of a major indicator for tobacco dependence.

Cigarette Smokers’ Use of Unconventional Tobacco Products and Associations With Quitting Activity: Findings From the ITC-4 U.S. Cohort

“…b User group was limited to those who used the product for the purpose of quitting cigarette smoking. (Bombard et al, 2007;Bombard et al, 2008;Richardson et al, 2012;Schuster et al, 2012;Tomar, 2010;Wetter et al, 2002). Interestingly, we found that those with lower incomes were more likely to use other smoked tobacco products or smokeless tobacco products for the purpose of cutting down on conventional cigarettes than were those with higher incomes.…”

“…For example, Wetter et al (2002) found that, among adult smokers, those who used both cigarettes and smokeless tobacco were less likely to stop all tobacco use than were those who only used one product or the other. Tomar, Alpert, and Connolly (2010) found that unsuccessful attempts to quit smoking were more prevalent among males who used snuff than among those who did not. Zhu et al (2009) found no advantage in cessation for men who switched to smokeless tobacco.…”

Use of Conventional and Novel Smokeless Tobacco Products Among US Adolescents

“…14 The relatively higher prevalence of smokeless tobacco use among boys and non-Hispanic whites found in our study is consistent with reports in the literature. [15][16][17][18] In addition, the important .002…”

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

“…This is explained by the lower likelihood of women being dual cigarette and ST users than exclusive ST users and the higher likelihood of women being dual cigarette and ST users when compared to exclusive smokers. Research has demonstrated that dual- and multi-product tobacco users experience lower cessation rates [17,18], possibly due to greater cotinine and dependence levels [50]. On average, AN smokers living in Bristol Bay smoke about half as many cigarettes (7.8) per day [42] as US smokers (14.2) [51], but demonstrate similar plasma cotinine levels (170 ng/mL and 200 ng/mL, respectively), suggesting altered nicotine metabolism [49,52].…”