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Learning Objectives: Describe the 1992-2002 epidemiological trends in smokeless tobacco (SLT) use and concurrent use of SLT and cigarettes
Abstract: PROBLEM: In response to the enduring public health problem of smoking and smoking-related disease, it is important to understand patterns of smokeless tobacco (SLT) use in the context of smoking patterns.
METHODS: The authors examine the 1992-2002 epidemiology of adult males' SLT use and smoking using the Current Population Survey-Tobacco Use Supplements (CPS-TUS), a nationally representative sample based on stratified clusters of households.
RESULTS: Consistent with declines in smoking, the prevalence of current SLT use declined over the period 1992-2002 by at least 0.8 percentage points and probably more (with estimates affected by changes in the measurement of ever use of SLT). The overall separate declines in SLT use and in smoking appear to be mirrored by a decline in concurrent use of SLT and cigarettes.
CONCLUSIONS: The findings suggest that reductions in smoking prevalence are accompanied by reductions in SLT use, even among concurrent users. CPS-TUS data allow for an imperfect assessment of SLT prevalence trends, but to the extent possible, confirmation of estimates using other nationally representative surveys should be undertaken. Given the potential policy implications of SLT use as a potential reduced exposure product (PREP), current survey methods require more careful measurement of SLT use in terms of initiation, duration, quantity, and cessation.
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