Transcript Breakout Session 14B: Current Trends in Smokeless Tobacco Use Among Wisconsin Adults presented by Daphne Kuo, Karen Palmersheim and Mark Wegner

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