US: Rate of Smokeless Tobacco Use Unchanged

While the portion of U.S. working adults smoking tobacco shrank appreciably between 2005 and 2010, the use of smokeless tobacco remained steady, according to a new study. 

In 2005, 2.7 percent of working adults represented in the annual National Health Interview Survey used smokeless tobacco and in 2010, it was 3 percent. That’s still about 10 times higher than national public health policy goals, researchers said.

“These findings highlight opportunities for reducing the health and economic burdens of tobacco use among U.S. workers, especially those in certain industries (e.g., mining) and occupations (e.g., construction and extraction) where use of smokeless tobacco is especially common,” the report’s authors write.

Dr. Jacek Mazurek, of the Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention (CDC), led the study that was published in the CDC’s Morbidity and Mortality Weekly Report. 

The researchers analyzed data on some 30,000 working adults collected in both 2005 and 2010. Survey participants answered questions about their jobs and their use of smokeless tobacco products such as snus and chewing tobacco, as well as their use of cigarettes.

Smokeless tobacco use was highest in certain industries and regions, the study team found. In mining, about 19 percent of workers used smokeless tobacco. About 9 percent of people employed in wholesale trades and 8 percent of construction workers were smokeless tobacco users as well. 

Among demographic groups, smokeless tobacco use was highest among white males ages 25 to 44 years old, people with no more than a high school education and those living in the Midwest and the South.

The study also found that about 4 percent of working adults who smoked cigarettes also used smokeless tobacco. 

In contrast with smokeless tobacco use, tobacco smoking rates fell among working adults from 22.1 percent in 2005 to 19.1 percent in 2010, the study team points out.

“The lack of reduction in smokeless tobacco use might be attributable to the introduction of novel smokeless tobacco products into the U.S. marketplace (e.g., snus and dissolvable tobacco), as well as increased expenditures on smokeless tobacco marketing in recent years,” the authors write in their report.

Lucy Popova, from the Center for Tobacco Control Research and Education at the University of California, San Francisco called the new study very timely.

“Cigarettes have been at the forefront of attention because they are the most harmful and the most deadly product out there, but there’s been a lot of efforts in the public health community, and cigarette smoking rates are going down, but we don’t see equal reduction in smokeless tobacco” Popova told Reuters Health.

Popova, who was not involved in the new study, said that a tobacco prevention program from the U.S. Food and Drug Administration called The Real Cost Campaign, plans to add a specific program targeted at smokeless tobacco use. 

The risks of smokeless tobacco include problems such as receding gums, loss of bones around the teeth, precancerous lesions, and cancers of the mouth, esophagus and pancreas, Popova said.

“The use of smokeless tobacco is also a risk factor in high blood pressure and cardiovascular disease and of course smokeless tobacco is addictive,” she said.

Popova highlighted a new finding in the report, that the average number of cigarettes smoked per day was significantly higher among dual users compared to those who used cigarettes only.

“People would expect that if you use two types of tobacco you’d smoke less – you would substitute and so you would reduce your harm, but what we see here is that people who are dual users actually smoke more,” she said.

But this makes sense, she said, because dual users become more dependent on tobacco and want a higher dose of nicotine.

The report’s authors note that past research indicates smokers may switch to smokeless tobacco because they think it’s safer than smoking, but it’s not and no evidence suggests it helps smokers transition to quitting.

They urge employers to make workplaces tobacco free and to offer tobacco-cessation support, and encourage healthcare providers and government to spread the message and fund tobacco-control programs. Enditem