Changes in smokeless tobacco consumption among men in the United States

Background: Recent changes in smokeless tobacco (SLT) marketing and the promotion of moist snuff as a harm-reduction product may increase SLT consumption. Previous studies which combined chew and moist snuff as aggregate SLT, suggested a decrease in overall SLT use. Methods: We analyzed data from the 2000 and 2005 National Health Interview Survey to assess the prevalence of current daily and/or some day chew, moist snuff and in aggregate SLT use among adult males for two survey years. Results: While the prevalence of SLT use among males remained stable (4.5%), chew tobacco use decreased from 2.5% in 2000 to 2.1% in 2005, and moist snuff use increased from 2.5% to 3.0%. Moist snuff use increased among white males (3.1% to 3.9%, p<0.05) and among males 18-44 years of age (3.4% to 4.4%, p<0.05). Moist snuff use also increased among other demographic subgroups of men, including daily cigarette smokers (2.6% to 3.9%), someday cigarette smokers (3.1% to 6.7%, p<0.05) and those with at least a college education (1.1% to 2.0%, p<0.05). Conclusion: Between 2000 and 2005, the overall prevalence of SLT use among men remained stable, chew tobacco use declined, and moist snuff use increased. Increases in snuff use among white males and smokers warrants attention. Reporting SLT use in aggregate masks changes in moist snuff and chew tobacco consumption, suggesting they should be reported separately when possible. Continued monitoring is necessary to accurately describe temporal trends in SLT use and to direct and evaluate tobacco control strategies.