Patterns and correlates of spit tobacco use among high school males in rural California.
OBJECTIVE
To assess patterns and correlates of spit [smokeless tobacco (ST)] use among high school males in rural California.


METHODS
An 18-item, self-administered questionnaire was used to assess ST use among young males in 41 randomly selected high schools in 21 rural counties in California. To ensure confidentiality, students were instructed to seal their completed questionnaire in an attached envelope prior to returning it to the questionnaire administrator.


RESULTS
Overall prevalence of ST use was 9.8 percent, significantly increasing with year in school from 5 percent among freshmen to 15 percent among seniors. ST use was highest among rodeo athletes at 42 percent compared with <6 percent among nonathletes; ST use was significantly higher among smokers (32 percent) who were 2.5-30 times more likely to use ST compared with nonsmokers, depending on race/ethnicity as a result of a significant race/ethnicity x smoking interaction of degree/magnitude. In addition, students who believed there was no, or slight risk of, harm from ST use were significantly more likely to use ST than students perceiving moderate or great risk, depending on race/ethnicity (odds ratios 3.6-13). Among all ST users, 40 percent used ST on at least 5 days in the previous week, 80 percent of those reporting a brand used the brand Copenhagen, and 41 percent (189) used ST within 30 minutes of waking.


CONCLUSIONS
Dental public health practitioners, scholars, and policy-makers need to promote dental health through organized community efforts targeting high school male subgroups in rural areas that are at risk for ST-associated adverse health effects.
Gansky
Stuart A
SA
Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA 94143-1361, USA.
Ellison
James A
JA
Kavanagh
Catherine
C
Isong
Umo
U
Walsh
Margaret M
MM
D000293:Adolescent; D002140:California; D003430:Cross-Sectional Studies; D006801:Humans; D012424:Rural Population; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000523:psychology*; D014030:Tobacco, Smokeless