title: Use of conventional and novel smokeless tobacco products among US adolescents.
abstract: OBJECTIVE
  To assess the prevalence and correlates of use of conventional and novel smokeless tobacco products among a national sample of US middle and high school students.
  
  
  METHODS
  Data from the 2011 National Youth Tobacco Survey were analyzed to determine national estimates of current use of conventional ("chewing tobacco", "snuff," or "dip"), novel ("snus" and "dissolvable tobacco products"), and any smokeless tobacco products (novel and/or conventional products) within the past 30 days.
  
  
  RESULTS
  The overall prevalence of current use of any smokeless tobacco product was 5.6% (n = 960). Among all students, 5.0% used chewing tobacco, snuff, or dip; 1.9% used snus; and 0.3% used dissolvable tobacco products. Among users of any smokeless tobacco, 64.0% used only conventional products, 26.8% were concurrent users of novel plus conventional products, whereas 9.2% exclusively used novel products. Approximately 72.1% of current any smokeless tobacco users concurrently smoked combustible tobacco products, and only 40.1% expressed an intention to quit all tobacco use. Regression analyses indicated that peer (adjusted odds ratio [aOR]: 9.56; 95% confidence interval [CI]: 7.14-12.80) and household (aOR: 3.32; 95% CI: 2.23-4.95) smokeless tobacco use were associated with smokeless tobacco use, whereas believing that all forms of tobacco are harmful was protective (aOR: 0.55; 95% CI: 0.38-0.79).
  
  
  CONCLUSIONS
  Conventional smokeless tobacco products remain the predominant form of smokeless tobacco use. Most users of novel smokeless tobacco products also concurrently smoked combustible tobacco products. Smokeless tobacco use was associated with lower perception of harm from all tobacco products and protobacco social influences, indicating the need to change youth perceptions about the use of all tobacco products and to engage pediatricians in tobacco use prevention and cessation interventions.
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA. iagaku@post.harvard.edu
authors.forename: Israel T
authors.initials: IT
authors.lastname: Agaku
authors.forename: Olalekan A
authors.initials: OA
authors.lastname: Ayo-Yusuf
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
authors.forename: Hillel R
authors.initials: HR
authors.lastname: Alpert
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Connolly
mesh_terms: D000293:Adolescent; D000329:Advertising; D001294:Attitude to Health; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D040261:Harm Reduction; D006306:Health Surveys; D006801:Humans; D007100:Imitative Behavior; D008297:Male; D010290:Parents; D010379:Peer Group; D011356:Product Labeling; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D012932:Social Facilitation; D013334:Students / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000009:adverse effects / Q000706:statistics & numerical data*; D014481:United States
keywords: addiction; adolescents; cigarette; harm reduction; smokeless; smoking; tobacco
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