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Trends in the use of smokeless tobacco in united states, 2000–2010


  • Neil Bhattacharyya MD, FACS

    Corresponding author
    1. Division of Otolaryngology, Brigham and Women's Hospital, Boston; and Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
    • Division of Otolaryngology, 45 Francis St., Boston, MA 02115
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  • Neil Bhattacharyya, MD, FACS, is a consultant for IntersectENT, Inc., and Entellus, Inc. The author has no other funding, financial relationships, or conflicts of interest to disclose.



To quantify trends in the use of smokeless tobacco in the United States.

Study Design:

Longitudinal analysis of national population database.


The National Health Interview Surveys for 2000, 2005, and 2010 were analyzed for adult responses to specific questions regarding smokeless tobacco use, which includes chewing tobacco and snuff. Smokeless tobacco lifetime exposure, current use, and frequency of use were determined according to each sampled year, examining for trends over the past decade. Subset analysis for young adults (ages 18–44 years) was conducted. Demographic factors associated with smokeless tobacco use were also determined.


A total of 86,270 adults were surveyed. Among all adults, the proportions of those who had ever tried chewing tobacco were 7.1 ± 0.2%, 8.5 ± 0.2%, and 9.2 ± 0.2% for 2000, 2005, and 2010, respectively (P < .001). Similarly, the proportions of those who had ever tried snuff were 4.4 ± 0.2%, 7.5 ± 0.2%, and 8.4 ± 0.3%, respectively (P < .001). In aggregate, the proportions who were regular users of chewing tobacco remained stable over the survey years: 1.3 ± 0.1%, 1.1 ± 0.1%, and 1.2 ± 0.1%, respectively (P = .382). In contrast, the percentages who were regular users of snuff tobacco increased significantly over the survey years: 1.4 ± 0.1%, 1.6 ± 0.1%, and 2.0 ± 0.1% (P < .001). The proportion of young adults regularly using snuff rose to 2.8 ± 0.2% (P < .001) in 2010. Male sex, non-Hispanic ethnicity, white race, and less than a high school education were characteristics that were strongly associated with smokeless tobacco use.


There was a trend toward increased smokeless tobacco use, mainly snuff, in the United States in the past decade. This trend was more prominent among young adults and likely will have future health-care implications. Laryngoscope, 2012

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