Current Trends in Smokeless Tobacco Use Among Wisconsin
Adults
Current Trends in Smokeless Tobacco Use Among Wisconsin
Adults
Daphne Kuo, Karen Palmersheim, Mark Wegner, and Patrick Remington
UW Carbone Cancer CenterUniversity of Wisconsin School of Medicine and Public Health
Wisconsin Department of Health Services
5th National Summit on Smokeless & Spit TobaccoMadison, WisconsinSeptember 22, 2009
Daphne Kuo, Karen Palmersheim, Mark Wegner, and Patrick Remington
UW Carbone Cancer CenterUniversity of Wisconsin School of Medicine and Public Health
Wisconsin Department of Health Services
5th National Summit on Smokeless & Spit TobaccoMadison, WisconsinSeptember 22, 2009
BackgroundBackgroundBackgroundBackground
Trends in smokeless tobacco (SLT) use Trends in smokeless tobacco (SLT) use have varied over time, depending on have varied over time, depending on type of producttype of product
Most data have shown a slow, but Most data have shown a slow, but steady decline of SLT use after the steady decline of SLT use after the mid-1990’s and through early the mid-1990’s and through early the 2000’s---particularly of chewing 2000’s---particularly of chewing tobacco and dry snufftobacco and dry snuff
However, tobacco consumption and However, tobacco consumption and sale data have shown an increase in sale data have shown an increase in the sale of snus (a moist type of snuff, the sale of snus (a moist type of snuff, doesn’t require spitting)doesn’t require spitting)
Trends in smokeless tobacco (SLT) use Trends in smokeless tobacco (SLT) use have varied over time, depending on have varied over time, depending on type of producttype of product
Most data have shown a slow, but Most data have shown a slow, but steady decline of SLT use after the steady decline of SLT use after the mid-1990’s and through early the mid-1990’s and through early the 2000’s---particularly of chewing 2000’s---particularly of chewing tobacco and dry snufftobacco and dry snuff
However, tobacco consumption and However, tobacco consumption and sale data have shown an increase in sale data have shown an increase in the sale of snus (a moist type of snuff, the sale of snus (a moist type of snuff, doesn’t require spitting)doesn’t require spitting)
ObjectivesObjectivesObjectivesObjectives
To examine trends in the prevalence To examine trends in the prevalence of SLT use among Wisconsin adultsof SLT use among Wisconsin adults
To compare trends in SLT use in To compare trends in SLT use in Wisconsin to that observed across the Wisconsin to that observed across the USUS
To investigate whether trends differ To investigate whether trends differ by type of smokeless productby type of smokeless product
To investigate whether trends differ To investigate whether trends differ by adult smoking statusby adult smoking status
To examine trends in the prevalence To examine trends in the prevalence of SLT use among Wisconsin adultsof SLT use among Wisconsin adults
To compare trends in SLT use in To compare trends in SLT use in Wisconsin to that observed across the Wisconsin to that observed across the USUS
To investigate whether trends differ To investigate whether trends differ by type of smokeless productby type of smokeless product
To investigate whether trends differ To investigate whether trends differ by adult smoking statusby adult smoking status
Data – SampleData – SampleData – SampleData – Sample
Wisconsin Data are somewhat Wisconsin Data are somewhat limiting!limiting!
Tobacco Use Supplement, Current Tobacco Use Supplement, Current Population Survey (US Census Bureau)Population Survey (US Census Bureau)
1995-96, 1998-99, 2001-02, 2003 and 1995-96, 1998-99, 2001-02, 2003 and 2006-072006-07
Wisconsin and US adults (18+)Wisconsin and US adults (18+)
Wisconsin Data are somewhat Wisconsin Data are somewhat limiting!limiting!
Tobacco Use Supplement, Current Tobacco Use Supplement, Current Population Survey (US Census Bureau)Population Survey (US Census Bureau)
1995-96, 1998-99, 2001-02, 2003 and 1995-96, 1998-99, 2001-02, 2003 and 2006-072006-07
Wisconsin and US adults (18+)Wisconsin and US adults (18+)
Variables and MethodsVariables and MethodsVariables and MethodsVariables and Methods
Ever use and current use of Ever use and current use of chewing tobacco, snuff chewing tobacco, snuff (may (may include snus)include snus), and the combination , and the combination of bothof both
Cigarette smoking status of the Cigarette smoking status of the respondentrespondent
Analyzed trends in the prevalence Analyzed trends in the prevalence of ever use and current use---in of ever use and current use---in the general population and by the the general population and by the smoking status of the respondentssmoking status of the respondents
Ever use and current use of Ever use and current use of chewing tobacco, snuff chewing tobacco, snuff (may (may include snus)include snus), and the combination , and the combination of bothof both
Cigarette smoking status of the Cigarette smoking status of the respondentrespondent
Analyzed trends in the prevalence Analyzed trends in the prevalence of ever use and current use---in of ever use and current use---in the general population and by the the general population and by the smoking status of the respondentssmoking status of the respondents
QuestionsQuestionsQuestionsQuestionsEver Use Ever Use (question has changed over (question has changed over
time)time)
1.1. Have you ever used pipes, cigars, Have you ever used pipes, cigars, chewing tobacco, or snuff on a chewing tobacco, or snuff on a regular basis? (if “Yes”---which regular basis? (if “Yes”---which ones?)ones?)
2.2. … … even one time?even one time?
3.3. … … ever used chewing tobacco,ever used chewing tobacco,
such as … ?such as … ?
… … ever used snuff, such as … ?ever used snuff, such as … ?
Ever Use Ever Use (question has changed over (question has changed over time)time)
1.1. Have you ever used pipes, cigars, Have you ever used pipes, cigars, chewing tobacco, or snuff on a chewing tobacco, or snuff on a regular basis? (if “Yes”---which regular basis? (if “Yes”---which ones?)ones?)
2.2. … … even one time?even one time?
3.3. … … ever used chewing tobacco,ever used chewing tobacco,
such as … ?such as … ?
… … ever used snuff, such as … ?ever used snuff, such as … ?
Questions, continued…Questions, continued…Questions, continued…Questions, continued…
Current UseCurrent Use
1.1. Do you now use … ?Do you now use … ?
2.2. Do you now use … every day,Do you now use … every day,
some days or not at all?some days or not at all?
Current UseCurrent Use
1.1. Do you now use … ?Do you now use … ?
2.2. Do you now use … every day,Do you now use … every day,
some days or not at all?some days or not at all?
Instrument change
Ever Use of SLT among Adults in Ever Use of SLT among Adults in Wisconsin and the US, TUS-CPS 1995-2007Wisconsin and the US, TUS-CPS 1995-2007
0%
5%
10%
15%
20%
1995-96 1998-99 2001-02 2003 2006-07
US ever chewing
WI ever chewing
US ever snuff
WI ever snuff
US ever SLT
WI ever SLT
FindingsFindings
The ever use of SLT, chewing tobacco The ever use of SLT, chewing tobacco and snuff appears to have increased and snuff appears to have increased among the adult population in among the adult population in Wisconsin and in the US since 1995.Wisconsin and in the US since 1995.
Wisconsin adults were more likely to Wisconsin adults were more likely to try chewing tobacco (and, thus, SLT) try chewing tobacco (and, thus, SLT) than the US adults.than the US adults.
Wisconsin adults were as likely to try Wisconsin adults were as likely to try snuff as US adults.snuff as US adults.
The ever use of SLT, chewing tobacco The ever use of SLT, chewing tobacco and snuff appears to have increased and snuff appears to have increased among the adult population in among the adult population in Wisconsin and in the US since 1995.Wisconsin and in the US since 1995.
Wisconsin adults were more likely to Wisconsin adults were more likely to try chewing tobacco (and, thus, SLT) try chewing tobacco (and, thus, SLT) than the US adults.than the US adults.
Wisconsin adults were as likely to try Wisconsin adults were as likely to try snuff as US adults.snuff as US adults.
Ever Use of SLT among Cigarette Smokers in
Wisconsin and the US, TUS-CPS 1995-2007
0%
5%
10%
15%
20%
1995-96 1998-99 2001-02 2003 2006-07US ever chewing
WI ever chewing
US ever snuff
WI ever snuff
US ever SLT
WI ever SLT
Instrument change
FindingsFindings
Current cigarette smokers were Current cigarette smokers were more likely to try SLT than other more likely to try SLT than other adults; and increases were adults; and increases were greater among current cigarette greater among current cigarette smokers than among the general smokers than among the general population.population.
WI smokers were more likely to try WI smokers were more likely to try chewing tobacco than US smokers.chewing tobacco than US smokers.
WI smokers were equally as likely WI smokers were equally as likely to try snuff as US smokers.to try snuff as US smokers.
Current cigarette smokers were Current cigarette smokers were more likely to try SLT than other more likely to try SLT than other adults; and increases were adults; and increases were greater among current cigarette greater among current cigarette smokers than among the general smokers than among the general population.population.
WI smokers were more likely to try WI smokers were more likely to try chewing tobacco than US smokers.chewing tobacco than US smokers.
WI smokers were equally as likely WI smokers were equally as likely to try snuff as US smokers.to try snuff as US smokers.
Current SLT Use among Adults in Wisconsin and the US, TUS-CPS 1995-2007
0%
1%
2%
3%
4%
5%
1995-96 1998-99 2001-02 2003 2006-07US current chewing
WI current chewing
US current snuff
WI current snuff
US current SLT
WI current SLT
FindingsFindings
National trendsNational trends in current SLT use in current SLT use in our study of the general in our study of the general population, till 2003, were population, till 2003, were consistent with findings from consistent with findings from previous studies.previous studies.
A slow but steady decline since A slow but steady decline since 1998 was observed for chewing 1998 was observed for chewing tobacco but not for snuff in the tobacco but not for snuff in the US.US.
National trendsNational trends in current SLT use in current SLT use in our study of the general in our study of the general population, till 2003, were population, till 2003, were consistent with findings from consistent with findings from previous studies.previous studies.
A slow but steady decline since A slow but steady decline since 1998 was observed for chewing 1998 was observed for chewing tobacco but not for snuff in the tobacco but not for snuff in the US.US.
FindingsFindings
Trends in current use of SLT and Trends in current use of SLT and chewing tobacco among chewing tobacco among WisconsinWisconsin adults were different from the adults were different from the national average since 1998.national average since 1998.
An increase in SLT (chewing An increase in SLT (chewing tobacco) use was observed in WI tobacco) use was observed in WI in 1998-1999, but not across the in 1998-1999, but not across the US.US.
Trends in current use of SLT and Trends in current use of SLT and chewing tobacco among chewing tobacco among WisconsinWisconsin adults were different from the adults were different from the national average since 1998.national average since 1998.
An increase in SLT (chewing An increase in SLT (chewing tobacco) use was observed in WI tobacco) use was observed in WI in 1998-1999, but not across the in 1998-1999, but not across the US.US.
FindingsFindings
Percentages of current use of SLT Percentages of current use of SLT and chewing tobacco in Wisconsin and chewing tobacco in Wisconsin declined slower than those in the declined slower than those in the US.US.
From 1998 through 2007, the From 1998 through 2007, the percentage of current chewing percentage of current chewing tobacco use (and SLT) was tobacco use (and SLT) was consistently higher in Wisconsin consistently higher in Wisconsin than in the US.than in the US.
Percentages of current use of SLT Percentages of current use of SLT and chewing tobacco in Wisconsin and chewing tobacco in Wisconsin declined slower than those in the declined slower than those in the US.US.
From 1998 through 2007, the From 1998 through 2007, the percentage of current chewing percentage of current chewing tobacco use (and SLT) was tobacco use (and SLT) was consistently higher in Wisconsin consistently higher in Wisconsin than in the US.than in the US.
FindingsFindings
The percentage of current snuff The percentage of current snuff use in Wisconsin was use in Wisconsin was consistently slightly lower than consistently slightly lower than that observed across the US that observed across the US from 1995 to 2007. from 1995 to 2007.
The percentage of current snuff The percentage of current snuff use in Wisconsin was use in Wisconsin was consistently slightly lower than consistently slightly lower than that observed across the US that observed across the US from 1995 to 2007. from 1995 to 2007.
Current SLT Use among Cigarette Smokers in Wisconsin and the US, TUS-CPS 1995-2007
0%
1%
2%
3%
4%
5%
1995-96 1998-99 2001-02 2003 2006-07
US current chewing
WI current chewing
US current snuff
WI current snuff
US current SLT
WI current SLT
FindingsFindings
The percentages of current use The percentages of current use of SLT, chewing tobacco and of SLT, chewing tobacco and snuff steadily increased over snuff steadily increased over time among current cigarette time among current cigarette smokers in Wisconsin.smokers in Wisconsin.
In the US, similar increases were In the US, similar increases were observed for snuff, but not for observed for snuff, but not for chewing tobacco.chewing tobacco.
The percentages of current use The percentages of current use of SLT, chewing tobacco and of SLT, chewing tobacco and snuff steadily increased over snuff steadily increased over time among current cigarette time among current cigarette smokers in Wisconsin.smokers in Wisconsin.
In the US, similar increases were In the US, similar increases were observed for snuff, but not for observed for snuff, but not for chewing tobacco.chewing tobacco.
ConclusionsConclusions
EverEver use of (experimentation with) use of (experimentation with) SLT increased between 1995 and SLT increased between 1995 and 2007 --- but we are not sure how 2007 --- but we are not sure how much of this change may be due to much of this change may be due to methodological issues (survey methodological issues (survey question)question)
CurrentCurrent overall use of SLT has not overall use of SLT has not change a lot in the general populationchange a lot in the general populationIn the more recent years, use of chewing In the more recent years, use of chewing
tobacco has decreased, use of snuff has tobacco has decreased, use of snuff has increased (perhaps due to the marketing increased (perhaps due to the marketing of snus)of snus)
EverEver use of (experimentation with) use of (experimentation with) SLT increased between 1995 and SLT increased between 1995 and 2007 --- but we are not sure how 2007 --- but we are not sure how much of this change may be due to much of this change may be due to methodological issues (survey methodological issues (survey question)question)
CurrentCurrent overall use of SLT has not overall use of SLT has not change a lot in the general populationchange a lot in the general populationIn the more recent years, use of chewing In the more recent years, use of chewing
tobacco has decreased, use of snuff has tobacco has decreased, use of snuff has increased (perhaps due to the marketing increased (perhaps due to the marketing of snus)of snus)
ConclusionsConclusions
WI vs. the US averageWI vs. the US average
Overall SLT use is slightly higher in Overall SLT use is slightly higher in Wisconsin than across the USWisconsin than across the US
This is due to greater use of chewing This is due to greater use of chewing tobacco in Wisconsintobacco in Wisconsin
Whereas, Wisconsinites are slightly Whereas, Wisconsinites are slightly less likely to use snuff/snus, than US less likely to use snuff/snus, than US adultsadults
WI vs. the US averageWI vs. the US average
Overall SLT use is slightly higher in Overall SLT use is slightly higher in Wisconsin than across the USWisconsin than across the US
This is due to greater use of chewing This is due to greater use of chewing tobacco in Wisconsintobacco in Wisconsin
Whereas, Wisconsinites are slightly Whereas, Wisconsinites are slightly less likely to use snuff/snus, than US less likely to use snuff/snus, than US adultsadults
ConclusionsConclusions
Cigarette smokers were more likely Cigarette smokers were more likely to ever use, and currently use SLT to ever use, and currently use SLT than the general population in WI than the general population in WI and the US.and the US.
Thus, smokers may be using Thus, smokers may be using smokeless products to compensate smokeless products to compensate for the inability to smoke in public for the inability to smoke in public places due to smoke-free places due to smoke-free restrictionsrestrictions
Cigarette smokers were more likely Cigarette smokers were more likely to ever use, and currently use SLT to ever use, and currently use SLT than the general population in WI than the general population in WI and the US.and the US.
Thus, smokers may be using Thus, smokers may be using smokeless products to compensate smokeless products to compensate for the inability to smoke in public for the inability to smoke in public places due to smoke-free places due to smoke-free restrictionsrestrictions
