title: Association of smokeless tobacco use and smoking in adolescents in the United States: an analysis of data from the Youth Risk Behavior Surveillance System survey, 2011.
abstract: BACKGROUND
  Using smokeless tobacco and smoking are behaviors that increase the risk of developing oral cancer, soft-tissue lesions, caries, periodontal disease and other oral conditions. The author conducted a study to examine use of smokeless tobacco and smoking by adolescents.
  
  
  METHODS
  The study was a cross-sectional analysis of participants with complete data regarding smoking, smokeless tobacco use and other variables of interest from the 2011 national Youth Risk Behavior Surveillance System survey (n = 9,655). The author performed descriptive analysis and multivariable logistic regression analyses.
  
  
  RESULTS
  The unadjusted odds ratio for smokeless tobacco use and smoking was 9.68 (95 percent confidence interval [CI], 7.72-12.13; P < .0001), and the adjusted odds ratio was 3.92 (95 percent CI, 2.89-5.31; P < .0001). Adolescents who used smokeless tobacco were more likely to be male, to smoke and to have engaged in binge drinking.
  
  
  CONCLUSIONS
  Adolescents who were using smokeless tobacco were more likely to be engaging in concomitant smoking and to be participating in other risk-taking behaviors. Practical Implications. Dentists are involved in helping patients with tobacco-use cessation. The association of smoking with using smokeless tobacco needs to be considered in the design of tobacco-use cessation programs for adolescents.
authors.affiliation: Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, 104A Health Sciences Center Addition, P.O. Box 9448, Morgantown, WV 26506, USA. rwiener2@hsc.wvu.edu
authors.forename: R Constance
authors.initials: RC
authors.lastname: Wiener
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001741:Black or African American / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology; D001213:Asian / Q000706:statistics & numerical data; D001334:Automobile Driving / Q000706:statistics & numerical data; D040343:Behavioral Risk Factor Surveillance System; D063425:Binge Drinking / Q000453:epidemiology; D015992:Body Mass Index; D002253:Carbonated Beverages / Q000706:statistics & numerical data; D003075:Coitus; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D050177:Overweight / Q000453:epidemiology; D012309:Risk-Taking; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D013177:Sports / Q000706:statistics & numerical data; D064424:Tobacco Use / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: Tobacco; Youth Risk Behavior Surveillance System survey; adolescence; cessation; smokeless tobacco; smoking; tobacco use
references.citation: J Subst Abuse. 1998;10(1):19-25
references.pmid: 9720003
references.citation: Addict Behav. 2012 Jul;37(7):866-70
references.pmid: 22464872
references.citation: Nicotine Tob Res. 2011 Jul;13(7):540-7
references.pmid: 21436294
references.citation: MMWR Surveill Summ. 2012 Jun 8;61(4):1-162
references.pmid: 22673000
references.citation: Tob Control. 2014 Sep;23(5):449-51
references.pmid: 23303287
references.citation: Regul Toxicol Pharmacol. 2013 Jun;66(1):1-5
references.pmid: 23454227
references.citation: Am J Public Health. 2012 Nov;102(11):2088-93
references.pmid: 22813086
references.citation: Nicotine Tob Res. 2011 Jun;13(6):431-9
references.pmid: 21385907
references.citation: J Psychopharmacol. 2013 Jan;27(1):13-8
references.pmid: 23035032
references.citation: Nicotine Tob Res. 2012 Aug;14(8):977-85
references.pmid: 22318693
references.citation: J Environ Public Health. 2012;2012:984561
references.pmid: 22666280
references.citation: J Adolesc Health. 2012 Apr;50(4):334-8
references.pmid: 22443835
references.citation: Am J Health Behav. 2004 Jan-Feb;28(1):63-71
references.pmid: 14977160
references.citation: Am J Public Health. 2010 Jan;100(1):78-87
references.pmid: 19910355
references.citation: J Environ Public Health. 2012;2012:493109
references.pmid: 22548091
references.citation: Nicotine Tob Res. 2011 Oct;13(10):965-71
references.pmid: 21624940
references.citation: Prev Med. 2004 Mar;38(3):309-17
references.pmid: 14766113
references.citation: Am J Addict. 2000 Summer;9(3):196-201
references.pmid: 11000915
references.citation: Tob Control. 2014 May;23(3):209-14
references.pmid: 23047885
references.citation: Am J Drug Alcohol Abuse. 2000 Feb;26(1):125-38
references.pmid: 10718168
references.citation: Tob Control. 2010 Apr;19(2):104-9
references.pmid: 20008157
references.citation: MMWR Recomm Rep. 2004 Sep 24;53(RR-12):1-13
references.pmid: 15385915
references.citation: Nicotine Tob Res. 2008 Nov;10(11):1581-9
references.pmid: 18988070
references.citation: Tob Control. 2014 Mar;23(2):107-12
references.pmid: 23117999
references.citation: Am J Public Health. 2006 Nov;96(11):1934-9
references.pmid: 17018821