How Many Americans Use Smokeless Tobacco?

I recently described how the federal government is all thumbs when it tries to count how many Americans smoke (here).  Further evidence of the government’s ineptitude is seen in the fact that the National Health Interview Survey (NHIS), the CDC’s official source for smoking statistics, only measures smokeless tobacco use every five years or so.  That leaves the National Survey on Drug Use and Health (NSDUH) as the government’s only annual source of data on smokeless use.

I analyzed NSDUH data from 2012 and found that 7.1% of adult men (roughly eight million) use smokeless tobacco, and the prevalence of smokeless use among women is minuscule (about one-half of one percent).  For obvious reasons, I’ll limit this discussion to men.   

NSDUH asks participants if they use “chewing tobacco” or “snuff.”  Over two-thirds of smokeless users in the survey, about 5.5 million, said they used only snuff, 1.2 million used only chewing tobacco, and 1.4 million used both.  However, participants’ responses to questions about smokeless brands used most often suggest that NSDUH misclassified some users.  The problem stems from the fact that consumers of smokeless products often use the terms “chew” or “dip snuff” interchangeably.

The most common brands among “snuff” users were Copenhagen (29%), Skoal (26%) and Grizzly (25%).  Other than Red Seal (4%) and Kodiak (4%), no other brand registered above 2%.  It is interesting to note that Camel Snus, the first pouched product that introduced the Swedish experience to American smokers, was the preferred brand for 1.7% of snuff users.

The misclassification problem is evident because 16% of “chewing tobacco” users favored Skoal, 11% picked Grizzly and 7% listed other moist snuff brands.  Red Man (25%), Levi Garrett (10%) and Beech-Nut (5%) were the top chewing tobacco brands.

Although 35% of smokeless users in this survey never smoked and 27% are former smokers, it is a tragedy that 38% are current smokers (a figure that is consistent with my previous research (discussed here).  That percentage means that 2.8 million smokeless tobacco users don’t recognize or are ignoring the significantly greater hazards of smoking.  Any ignorance on their part may be traced to the deliberate campaign by the CDC, FDA NIH and other tobacco prohibitionists to deny Americans vital facts about the relative risks of smoking and smokeless use.  This misinformation campaign conflates risk data to damn equally all forms of tobacco. The FDA declares, (here) “Tobacco products are harmful yet widely used consumer products that are responsible for severe health problems…[including] cancer, lung disease, and heart disease, which often lead to death.” The CDC asserts, (here) “Tobacco use is the leading preventable cause of death in the United States.”

Lies of omission like these tell eight million American smokeless users: “You might as well smoke.”  That is a travesty.