Epidemiology of smokeless tobacco use: a national study.

The prevalence and patterns of smokeless tobacco use and its correlates were assessed in the National Institute on Drug Abuse National Household Survey of residents 12 years of age and older. Overall, 11% of the general population have "ever tried" chewing tobacco, snuff, or other smokeless tobacco. Of these, 5% were former users and 3% used smokeless tobacco almost daily in the past year. Rates of its use differed significantly by sex, age group, race, region, and metropolitan area size. Although females were far less likely to try it, those who did were as likely as males to be daily users. Smokeless tobacco users were also more likely to use alcohol, cigarettes, and marijuana. In general, those who used smokeless tobacco almost daily were more likely to report poor health and hospitalization for illness or injury in the past year, even when other substance use was controlled. Smokeless tobacco users also were more likely to report symptoms of depression. Finally, some substituted smokeless tobacco for cigarettes, but youths (12-17 yr old) were more likely than older tobacco users to use both forms of tobacco regularly.