TABLE 2

Concurrent Use Pattern of Smokeless Tobacco With Other Tobacco Products, Perceptions, Social Influences, and Adjusted Effect of Characteristics on Current Any Smokeless Tobacco Use, 2011 National Youth Tobacco Survey

Proportion of Students, % (95% CI)Adjusted Effect on Smokeless Tobacco Use, aORb (95% CI)
CharacteristicNonusers of Any Smokeless Tobacco Product (n = 17 589)Snus or Dissolvable Tobacco Product Users Only (n = 114)Snuff or Chewing or Dipping Tobacco Users Only (n = 617)Combined Users of Snus or Dissolvable Tobacco Products Plus Snuff or Chewing or Dipping Tobacco (n = 221)Users of Any Smokeless Tobacco Producta (n = 960)
Concurrent use of other tobacco products
 Current smoking of any combustible tobaccoc13.0 (11.6–14.4)80.5 (70.6–90.4)65.2 (59.1–71.4)82.3 (76.9–87.7)72.1 (67.4–76.8)5.91 (4.36–7.99)* (Ref = nonsmokers)
 Current use of electronic cigarettes0.6 (0.4–0.8)8.6 (2.6–14.5)3.9 (1.9–6.0)19.2 (12.7–25.7)8.5 (5.9–11.0)2.95 (1.62–5.37)* (Ref = nonusers)
 Current use of other “new tobacco products” not specified1.2 (0.9–1.4)15.6 (11.1–20.2)20.0 (13.2–26.9)16.3 (12.5–20.2)4.11 (2.47–6.87)* (Ref = nonusers)
Beliefs, attitudes, and perceptions
 Self-report that it would be easy or somewhat easy to get tobacco60.6 (57.9–63.4)93.7 (88.1–99.3)92.6 (89.0–96.1)97.1 (94.6–99.6)93.9 (91.5–96.2)2.22 (1.35–3.63)* (Ref = not easy)
 Belief that all tobacco products are harmful91.6 (90.8–92.4)67.6 (57.7–77.4)67.9 (63.0–72.8)64.6 (57.6–71.6)67.0 (63.3–70.7)0.55 (0.38–0.79)* (Ref = not harmful)
Exposure to smokeless tobacco health warning labels
 Saw warning label on smokeless tobacco products in past 30 daysd47.9 (45.1–50.8)64.0 (50.0–78.0)75.7 (70.8–80.7)86.3 (81.1–91.5)78.1 (74.0–82.2)2.68 (1.93–3.74)* (Ref = never or rarely)
Exposure and receptivity to tobacco advertisement
 Exposure to tobacco advertisements at billboard or store51.5 (49.3–53.7)68.7 (55.8–81.5)69.9 (64.5–75.3)73.3 (66.3–80.2)70.8 (66.5–75.1)1.24 (0.93–1.65) (Ref = never or rarely)
 Likely to use or wear something with tobacco company name or picture16.0 (14.9–17.2)56.9 (46.9–66.9)57.8 (53.3–62.2)64.2 (55.2–73.2)59.4 (55.6–63.3)1.68 (1.26–2.25)* (Ref = not likely)
 Bought or received something with tobacco company name/picture in past 12 months10.5 (9.7–11.3)39.2 (29.9–48.6)41.1 (35.7–46.5)52.1 (43.9–60.2)44.0 (39.8–48.1)1.41 (1.01–1.99)* (Ref = no purchase/receipt)
Protobacco influences
 One or more close friends smokes cigarettes29.7 (27.4–31.9)73.2 (63.6–82.7)74.5 (70.0–78.9)85.3 (79.4–91.2)77.4 (74.3–80.5)0.82 (0.59–1.12) (Ref = none)
 One or more close friends uses smokeless tobacco12.9 (11.0–14.8)41.9 (30.0–53.7)79.2 (75.0–83.4)91.6 (87.4–95.9)79.2 (76.2–82.3)9.56 (7.14–12.80)* (Ref = none)
 One or more persons in household smokes any combustible tobacco35.6 (32.9–38.2)49.4 (40.5–58.4)54.8 (49.2–60.4)65.7 (57.7–73.8)57.3 (52.4–62.1)0.96 (0.73–1.27) (Ref = none)
 One or more persons in household uses smokeless tobacco7.1 (5.6–8.6)10.9 (3.3–18.5)34.9 (28.0–41.8)45.5 (38.1–52.9)35.6 (30.5–40.7)3.32 (2.23–4.95)* (Ref = none)
  • All data were weighted to account for the complex survey design. Ref, referent category; —, estimate not reported because relative SE was ≥40%.

  • a Any smokeless tobacco use was defined as use of at least 1 of the following tobacco products on ≥1 days during the past 30 days: snus, dissolvable tobacco products, or snuff or chewing or dipping tobacco.

  • b Adjusted for age, gender, race/ethnicity, school level, current use of smoked tobacco products, receptivity toward protobacco advertisements (as measured by buying or receiving an item with a tobacco name or picture), and protobacco peer and household influences.

  • c Current use of any combustible tobacco product was defined as use of at least 1 of the following tobacco products on ≥1 days during the past 30 days: cigarettes (including flavored cigarettes and roll-your-own cigarettes), cigars (including clove cigars and flavored little cigars), bidis, kreteks, pipes, and waterpipes/hookahs.

  • d Among students who reported seeing a smokeless tobacco product within the past 30 days.

  • * Significant at P < .05.