Smokeless tobacco use among ninth graders in a north-central metropolitan population: cross-sectional and prospective associations with age, gender, race, family structure, and other drug use.

Smokeless tobacco use was analyzed in relation to demographic factors and to past and current use of tobacco, alcohol, and marijuana in 4,249 ninth graders in the Twin Cities metropolitan area. Smokeless tobacco use was found to be more common among males, particularly whites; among whites relative to blacks; among adolescents from one-parent households; and among those who reported current or prior use of cigarettes, alcohol, or marijuana. Smokeless tobacco use was also very common among the Native Americans and Hispanics sampled. The results suggest that smokeless tobacco may be joining the list of common recreational drugs that have potential for both short and long-term danger to the adolescent user.