Smokeless tobacco and dual use among firefighters in the central United States.

Little is known about smokeless tobacco (SLT) use in the fire service, whose personnel need to maintain high levels of health and fitness given the rigorous physical and mental job requirements. We examined the relationships among variables associated with SLT use and dual tobacco use (SLT and smoking) among 353 male career firefighters. Around 13% of male career firefighters reported being current exclusive SLT users, and 2.6% used both cigarettes and SLT. Age-adjusted models revealed that race, binge drinking, and dietary fat consumption were positively associated with exclusive SLT use when compared to nontobacco users. SLT users were much more likely to binge drink (OR = 3.98, P < .01) and consume high fat foods (OR = 1.94, P < .05). Only high dietary fat consumption was a strong correlate (OR = 8.41, P < .05) of dual use when compared to nontobacco users. SLT and dual tobacco use are associated with significant health risks. Detailed information on the predictors of SLT use among firefighters will aid in developing more effective tobacco prevention and cessation intervention in fire service.