In 2005, 2.7 percent of working adults represented in the annual
National Health Interview Survey used smokeless tobacco and in 2010,
it was 3 percent. That’s still about 10 times higher than national
public health policy goals, researchers said.
“These findings highlight opportunities for reducing the health and
economic burdens of tobacco use among U.S. workers, especially those
in certain industries (e.g., mining) and occupations (e.g.,
construction and extraction) where use of smokeless tobacco is
especially common,” the report’s authors write.
Dr. Jacek Mazurek, of the Division of Respiratory Disease Studies,
National Institute for Occupational Safety and Health at the Centers
for Disease Control and Prevention (CDC), led the study that was
published in the CDC’s Morbidity and Mortality Weekly Report.
The researchers analyzed data on some 30,000 working adults
collected in both 2005 and 2010. Survey participants answered
questions about their jobs and their use of smokeless tobacco
products such as snus and chewing tobacco, as well as their use of
Smokeless tobacco use was highest in certain industries and regions,
the study team found. In mining, about 19 percent of workers used
smokeless tobacco. About 9 percent of people employed in wholesale
trades and 8 percent of construction workers were smokeless tobacco
users as well.
Among demographic groups, smokeless tobacco use was highest among
white males ages 25 to 44 years old, people with no more than a high
school education and those living in the Midwest and the South.
The study also found that about 4 percent of working adults who
smoked cigarettes also used smokeless tobacco.
In contrast with smokeless tobacco use, tobacco smoking rates fell
among working adults from 22.1 percent in 2005 to 19.1 percent in
2010, the study team points out.
“The lack of reduction in smokeless tobacco use might be
attributable to the introduction of novel smokeless tobacco products
into the U.S. marketplace (e.g., snus and dissolvable tobacco), as
well as increased expenditures on smokeless tobacco marketing in
recent years,” the authors write in their report.
Lucy Popova, from the Center for Tobacco Control Research and
Education at the University of California, San Francisco called the
new study very timely.
“Cigarettes have been at the forefront of attention because they are
the most harmful and the most deadly product out there, but there’s
been a lot of efforts in the public health community, and cigarette
smoking rates are going down, but we don't see equal reduction in
smokeless tobacco” Popova told Reuters Health.
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Popova, who was not involved in the new study, said that a tobacco
prevention program from the U.S. Food and Drug Administration called
The Real Cost Campaign, plans to add a specific program targeted at
smokeless tobacco use.
The risks of smokeless tobacco include problems such as receding
gums, loss of bones around the teeth, precancerous lesions, and
cancers of the mouth, esophagus and pancreas, Popova said.
“The use of smokeless tobacco is also a risk factor in high blood
pressure and cardiovascular disease and of course smokeless tobacco
is addictive,” she said.
Popova highlighted a new finding in the report, that the average
number of cigarettes smoked per day was significantly higher among
dual users compared to those who used cigarettes only.
“People would expect that if you use two types of tobacco you’d
smoke less - you would substitute and so you would reduce your harm,
but what we see here is that people who are dual users actually
smoke more,” she said.
But this makes sense, she said, because dual users become more
dependent on tobacco and want a higher dose of nicotine.
The report’s authors note that past research indicates smokers may
switch to smokeless tobacco because they think it’s safer than
smoking, but it’s not and no evidence suggests it helps smokers
transition to quitting.
They urge employers to make workplaces tobacco free and to offer
tobacco-cessation support, and encourage healthcare providers and
government to spread the message and fund tobacco-control programs.
Morbidity and Mortality Weekly Report, online June 6, 2104.
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