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Smokeless Tobacco Use Widespread in Some States

THURSDAY, Nov. 4 (HealthDay News) -- Many smokers in the United States and its territories also use smokeless tobacco products such as snuff and chew tobacco, a combination that makes quitting much more difficult, a new federal study shows.

Researchers analyzed data from the 2009 Behavioral Risk Factor Surveillance System and found that the rate of smokers who also use smokeless tobacco ranged from 0.9 percent in Puerto Rico to 13.7 percent in Wyoming.

"The war against tobacco has taken on a new dimension as parts of the country report high rates of cigarette smoking and smokeless tobacco use among adults. The latest data from the Centers for Disease Control and Prevention reveal disturbing trends in smoking prevalence as more individuals use multiple tobacco products to satisfy their nicotine addiction," American Heart Association CEO Nancy Brown said in a statement released Thursday. "No tobacco product is safe to consume. The health hazards associated with tobacco use are well-documented and a recent American Heart Association policy statement indicates smokeless tobacco products increase the risk of fatal heart attack, fatal stroke and certain cancers."

Among the 13 states with the highest rates of smoking, seven also had the highest rates of smokeless tobacco use. In these states -- Alabama, Alaska, Arkansas, Kentucky, Mississippi, Oklahoma and West Virginia -- at least one of every nine men who smoked cigarettes also reported using smokeless tobacco. The rates in those states ranged from 11.8 percent in Kentucky to 20.8 percent in Arkansas.

The state with the highest rate of smokeless tobacco use among adult male smokers was Wyoming (23.4 percent).

Smokeless tobacco use was highest among men, young adults aged 18 to 24 and people with a high school education or less, according to the study. Smokeless tobacco use was highest in Wyoming (9.1 percent) and West Virginia (8.5 percent) and lowest in the U.S. Virgin Islands (0.8 percent) and California (1.3 percent).

Smoking rates were highest in Kentucky (25.6 percent), West Virginia (25.6 percent) and Oklahoma (25.5 percent), and lowest in Utah (9.8 percent), California (12.9 percent), and Washington (14.9 percent).

The findings are published in the Nov. 5 issue of Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.

"Tobacco use is the leading preventable cause of death in this country and unfortunately smokers are also using smokeless tobacco," CDC Director Dr. Tom Frieden said in an agency news release.

"If you smoke, quitting is the single most important thing you can do to improve your health. 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," he added.

"These new numbers are concerning. But progress is possible," Dr. Tim McAfee, director of the CDC's Office on Smoking and Health, said in the news release. "We need to fully put into practice effective strategies such as strong state laws that protect nonsmokers from secondhand smoke, higher tobacco prices, aggressive ad campaigns that show the human impact of tobacco use, and well-funded tobacco control programs, while stepping up our work to help people quit using all forms of tobacco."

More information

The U.S. National Cancer Institute has more about smokeless tobacco.

-- Robert Preidt

SOURCE: U.S. Centers for Disease Control and Prevention, news release; Nov. 4, 2010; Nov. 4, 2010, statement, American Heart Association; Nov. 5, 2010, Morbidity and Mortality Weekly Report

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