Patterns of use and incidence of smokeless tobacco consumption in school-age children.

A sample of 5,392 students were surveyed using a 42-item, multiple-choice questionnaire from a population of 19,040 Texas school-age children. The geographic distribution was 70% urban and 30% rural, with a representative sampling of the various racial and ethnic groups within Texas. The results of the survey indicated that 486 (9%) of the students regularly used smokeless tobacco, 810 (15%) regularly smoked cigarettes, and 4,096 (76%) used no tobacco products. Further, 77% perceived cigarette smoking as very harmful, while only 40% perceived smokeless tobacco as very harmful. Age of initiating use indicated that 55% of smokeless tobacco users started before the age of 13 years, whereas only 36% of cigarette smokers began that early.