Relatively little is known about the trends in the use of smokeless tobacco (SLT) use among youth. This paper analyses data from the National Youth Tobacco Survey (NYTS) to shed some light in SLT use patterns and temporal trends among middle-school and high-school students nationwide.

Methods:

We will analyze NYTS survey data to characterize SLT prevalence in urban and rural areas across different racial and ethnic groups. The analysis will be stratified by gender and grade level. Estimated prevalence and subgroup differences will be estimated and tested statistically with methods that account for the complex survey sampling design. Trends will be computed and tested using data concatenated from multiple cycles of the NYTS survey. We will test the hypotheses that prevalence may be increasing for SLT in certain subgroups in contrast with the prevalence of cigarette use.

Results:

We expect to show that SLT prevalence rates vary across key demographic subgroups, being higher in rural areas, for example. We will also show that prevalence rates for SLT have not leveled off in recent years; on the contrary, they have increased.

Conclusions:

In contrast to cigarette use, SLT use has not decreased in recent years. Educational campaigns may target groups where the rates have been increasing.