The use of smokeless tobacco— snuff and chewing tobacco—is associated with a substantially higher risk of developing oral cancer.39 Data from the Monitoring the Future Study indicate that smokeless tobacco use among youth has generally decreased in recent years. Data from the Youth Risk Behavior Survey provide additional information about smokeless tobacco use by males and females within racial and Hispanic groups.
Differences by Age.40 In general, as age and/or grade increases, so does the prevalence of smokeless tobacco use. In 1999, the percentage of students who reported using smokeless tobacco over the previous 30 days was 4.5 percent among 8th graders, 6.5 percent among 10th graders, and 8.4 percent among 12th-grade students (see Table SD 3.2.A). The rate for 12th-grade students decreased from 12.2 percent in 1995 to 8.4 percent in 1999.
Differences by Gender. While rates of youth cigarette smoking are similar among males and females (see section SD 3.1), male students in the 8th, 10th, and 12th grades are more likely to use smokeless tobacco than are female students (see Figure 3.2.A). In 1999, among 12th-grade students, 15.5 percent of males and 1.3 percent of females reported smokeless tobacco use (see Table 3.2.A).
Differences by Race and Grade.41The use of smokeless tobacco is most prevalent among white youth. In 1999, 11 percent of white 12th graders reported having used smokeless tobacco one or more times in the 30 days preceding the survey, compared with 3.9 percent of Hispanic 12th graders and 1.5 percent of black 12th graders (see Table SD 3.2.A).
The rate of smokeless tobacco use increases for white students as grade level increases. In 1999 among white students, the prevalence of smokeless tobacco use was 5.4 percent among 8th graders, 8.7 percent among 10th graders, and 11 percent among 12th graders (see Table 3.2.A).
The Youth Risk Behavior Survey provides additional subgroup information for 9th- through 12th-grade students combined. According to this survey’s most recent administration in 1999, the use of smokeless tobacco is most prevalent among white, non-Hispanic male high school students, with 19 percent reporting having used smokeless tobacco one or more times in the 30 days preceding the survey, compared with 6 percent of Hispanic male youth and 3 percent of black male youth (see Figure SD 3.2.B).
39 U.S. Department of Health and Human Services, Centers for Disease Control. 1999. Targeting Tobacco Use: The Nation’s Leading Cause of Death: At-a-Glance. Atlanta, GA.: Centers for Disease Control. See also Tomar, S.L., & Henningfield, J.E. 1995. Additional Evidence Implicating Moist Snuff as a Potent Carcinogen. Journal of the National Cancer Institute 87 (24): 1822-1823.
40 According to Sherry Everett Jones at the Center for Disease Control, differences by grade are not statistically significant.
41 In Table SD 3.2.B and Figure SD 3.2.B, estimates for whites and blacks exclude Hispanics of those races.
Table SD 3.2.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported using smokeless tobacco over the previous 30 days, by grade, gender, and race and Hispanic origin: Selected years, 1992-1999
|Race and Hispanic origina
|Race and Hispanic origina
|Race and Hispanic origina
a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
b Estimates for race and Hispanic origin represent the mean of the specified year and the previous year. Data have been combined to increase subgroup sample sizes, thus providing more stable estimates.
Note: Prevalence of smokeless tobacco was not asked of 12th graders in 1990 and 1991. Prior to 1990, the prevalence question on smokeless tobacco was located near the end of one 12th-grade questionnaire form, whereas after 1991, the question was placed in a different and earlier form in the questionnaire. This shift could explain the discontinuities between the corresponding data in later years. Data for 8th and 10th grades have been available since 1991.
Sources: Johnston, O’Malley, & Bachman, 2000, 8th and 10th grade Table D-33; 12th grade Table D-34. Data for 1999: prepublication detail tables provided by Monitoring the Future Study staff: 8th and 10th grade Table D-52; 12th grade Table D-53.
Figure SD 3.2.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported using smokeless tobacco during the previous 30 days, by gender: 1999
Source: The Monitoring the Future Study, The University of Michigan. Prepublication detail tables provided by the Monitoring the Future Study staff: 8th and 10th grade Table D-52; 12th grade Table D-53.
Figure SD 3.2.B Percentage of youth in grades 9 through 12 in the United States who reported having used smokeless tobacco during the previous 30 days, by gender and by race and Hispanic origin:a 1999
a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: Kan, et al. 1998, Table 12, p. 50.
Table SD 3.2.B Percentage of youth in grades 9 through 12 in the United States who reported having used smokeless tobacco during the previous 30 days,a by gender and by race and Hispanic origin:b 1991, 1993, 1995, 1997, and 1999
|Race and Hispanic originb|
a In 1991 and 1993, students were asked whether they had “used chewing tobacco or snuff during the 30 days preceding the survey;” in 1995 1997, and 1999, students were asked how many days they had “used chewing tobacco or snuff on 1 or more of the 30 days preceding the survey.”
b Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Centers for Disease Control and Prevention. 1990-1991, Table 1, p. 50; Kann, et al., 1995, Table 12, p. 35; Kann, et al., 1996, Table 12, p. 44; Kann, et al., Table 12, p. 50.
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