WASHINGTON, DC—Many who smoke are also using smokeless tobacco.

New data compiled by CDC that covers use of smokeless tobacco in all 50 states, the District of Columbia, the US Virgin Islands, Puerto Rico, and Guam found that the rates of smokers who also use smokeless tobacco, including chew tobacco and snuff, range from 0.9% in Puerto Rico to 13.7% in Wyoming.

“Tobacco use is the leading preventable cause of death in this country,” said CDC Director Tom Frieden, MD, MPH, in a written statement. “Use of smokeless tobacco may keep some people from quitting tobacco altogether. We need to intensify our anti-tobacco efforts to help people quit using all forms of tobacco.”

Topping the list of smokeless tobacco use within the states was Wyoming (9.1%), West Virginia (8.5%), and Mississippi (7.5%), the report indicated. Its use was lowest in California (1.3%), DC (1.5%), Massachusetts (1.5%), and Rhode Island (1.5%) Among US territories, the prevalence of smokeless tobacco was 0.8% in US Virgin Islands, 1.4% in Puerto Rico, and 4.1% in Guam.

The findings were published in the Nov 5th issue of CDC’s Morbidity and Mortality Weekly Report, and were based on data collected from the 2009 Behavioral Risk Factor Surveillance System, which is conducted annually in all 50 states, DC, Guam, Puerto Rico, and the US Virgin Islands.

The report found that among the 25% of states in which cigarette smoking prevalence was greatest, seven also had the highest prevalence of smokeless tobacco use: Alabama, Alaska, Arkansas, Kentucky, Mississippi, Oklahoma, and West Virginia. In these states, at least one of every nine men who smoked cigarettes also reported using smokeless tobacco.

Smokeless tobacco use among men was significantly higher than among women in all 50 states. Among the 50 states and DC, smokeless tobacco use was most common among persons aged 18 to 24 years. Smokeless tobacco use also tended to decrease with increasing education, according to the report. “These data suggest that smokeless tobacco use is predominantly a public health problem among men, young adults, and persons with lower education, and in certain states,” according to the report.

The report stated that in order to promote cessation among tobacco users, providers, including dentists and dental hygienists, should ask their patients about all forms of tobacco use, advise them to quit using all forms of tobacco, assess their willingness to quit, assist them in quitting, and arrange for follow-up contacts. “This approach, in combination with comprehensive tobacco control measures, as recommended by WHO and CDC’s Community Guide to Preventive Services that address all forms of tobacco, including raising excise taxes on cigarettes and all other tobacco products, can help to prevent tobacco-
related deaths,” the report stated.

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