Wednesday, June 24, 2009

Not the Spitting Image: The Social Transformation of Smokeless Tobacco Use

Smokeless tobacco has carried a social stigma for years. The typical user has been characterized as a ballplayer or cowboy, spitting quantities of tobacco juice. New research, published in the July 2009 issue of the American Journal of Preventive Medicine, provides fascinating information that redefines contemporary smokeless tobacco users.

The new study by David Timberlake and Jimi Huh at the University of California-Irvine used 2003-2005 data from the government’s National Survey on Drug Use and Health. Timberlake and Huh identified four groups of men who use smokeless tobacco and the percentage of all users that they represent: 1) Older chew users (17%), 2) Young poly-tobacco users (29%), 3) Skilled laborers (28%), and 4) Educated professionals (27%). Here are some interesting characteristics of each group.

Group 1: Older chew users. Only about one in five of these men went to college, while a third didn’t finish high school. Almost half are former smokers, confirming previous research showing that smokeless tobacco has been used as a cigarette substitute and smoking cessation method. In fact, 88% of former smokers quit over three years ago, so switching to smokeless was not only successful, it was sustainable.

Group 2: Young poly-tobacco users. Seventy percent of this group are age 18-25 years, and almost all are unmarried. Six out of ten only use moist snuff, and most use smokeless tobacco only on some days. About half are cigarette smokers. Obviously, these poly-tobacco users are getting nicotine satisfaction from both forms of tobacco. If they knew that smokeless tobacco use is 98% safer than smoking, they would likely abandon cigarettes altogether.

Group 3: Skilled laborers. Eighty-five percent of this group are age 26-49 years, and almost 70% are high school graduates. They are the most likely of all smokeless users to live outside cities. Most use only moist snuff, and they use it daily.

Group 4: Educated Professionals. Nearly 90% attended college. The majority live in small or large cities, and most use only moist snuff. Also notable: 60% of professionals have never smoked, and 20% are former smokers.

This study revealed that American smokeless tobacco users are considerably diverse with respect to education, occupation and other characteristics. Timberlake and Huh concluded that "…educated professionals defy many of the common stereotypes of male smokeless tobacco users. More demographic heterogeneity in smokeless tobacco users may translate to greater appeal among cigarette smokers considering smokeless tobacco as a substitute."

Starting about 15 years ago, health professionals at the American Cancer Society, the Centers for Disease Control, the Mayo Clinic and other anti-tobacco organizations began to denigrate users by describing smokeless products as "spit tobacco." These derogatory characterizations were always unprofessional. But the new research shows that they are no longer accurate, because American smokeless tobacco users are discarding the "spitting" image.

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