2007 National Conference on Tobacco or Health

Thursday, October 25, 2007
Exhibit Hall

Trends in Smokeless Tobacco Use in the US Workforce: 1987-2005

David J. Lee, PhD, University of Miami, Sylvester Comprehensive Cancer Center, dlee@med.miami.edu, Lora Fleming, MD, lfleming@med.miami.edu, Noella Dietz, PhD, ndietz@med.miami.edu, Bill LeBlanc, PhD, thedatadoctor@gmail.com, Katherine Chung-Bridges, MD, KChung@med.miami.edu, Sharon Christ, MS, slchrist@email.unc.edu, Kathryn McCollister, PhD, KMcColli@med.miami.edu.

Learning Objectives: Identify the major US worker groups with the highest rates of smokeless tobacco use

Problem/Objective: Smokeless tobacco use is associated with adverse health outcomes and cannot be considered a risk-free alternative to smoked tobacco products. It is unknown if the prevalence of smokeless tobacco use is increasing in worker populations in response to increasing workplace smoking restrictions.

Methods: The National Health Interview Survey is a nationally-representative survey of the US civilian population. Current smokeless tobacco use and occupational status were assessed over survey periods 1987, 1991-1994, 1998, 2000, and 2005 (n=141,171). To assess smokeless tobacco use trends, a weighted linear regression model was fitted to the annual design-adjusted rates within occupational groups. The weight used for each annual rate was the inverse of its variance.

Results: There were no significant upward or downward trends in smokeless tobacco rates within blue-collar, white-collar, service workers, and farm workers. However there were significant differences in the prevalence rates between worker categories. For example, in 2005 the survey-adjusted prevalence rates were significantly higher in farm workers (12.5%; [95% CI 5.0-19.9]) and blue-collar workers (5.6% [4.5-6.7]) versus white-collar (1.7% [1.4-2.0]) and service workers (1.9% [1.3-2.6]).

Conclusions: Smokeless tobacco rates are stable, but there are large differences in use across worker groups. Smokeless tobacco prevention strategies specifically targeting farm workers and blue-collar groups are warranted.