Adult smoking rates in the USA vary greatly according to state, with West Virginia and Kentucky at 25.6% to Washington at 14.9%, California at 12.9%, and Utah at 9.8%. In none of the US states and territories was smoking prevalence higher among adult females than males.

The Centers for Disease Control and Prevention (CDC) in its latest Morbidity and Mortality Weekly Report explains that the clear risks linking smoking to several diseases, including lung, throat, oral and other cancers, as well as cardiovascular and respiratory diseases have been well documented and publicized. The report examined state-specific current smoking prevalence and smokeless tobacco use among US adults by gathering information from the 2009 Behavioral Risk Factor Surveillance System (BRFSS). BRFSS has data on 432,607 adults, their age, sex, education levels, tobacco habits, and how many people share their household.

18 to 24 year-olds, as well as individuals with a high school education or less are more likely to use smokeless tobacco products, compared to other adults, the report explains. A significant proportion of current regular smokers also use smokeless tobacco products, such as Wyoming with 13.7%. The CDC says that doctors should explain to their patients that attempting to quit smoking should include all tobacco products, smoking and smokeless ones.

Smokeless tobacco use overall – including smokers and non smokers – was highest in Wyoming at 9.1% and lowest in California at 1.3%. In all 50 states, smokeless tobacco use was significantly higher among men than women.

Smokeless tobacco product usage is on the increase in the USA. The report’s authors believe it is due to legislation which bans smoking in bars, restaurants, airplanes and other public and enclosed places. Smokeless tobacco can also be used in the workplace, where in most cases lighting up is not allowed, unless you have an outdoor occupation, such as gamekeeper or fisherman.

Tobacco companies often market smokeless tobacco products as an alternative to smoking. However, the report stresses that they do not help you quit. The addictive element in smoking is nicotine, which exists in tobacco. If the smoker switches to smokeless tobacco, the addiction continues, and with it a high risk of falling into the slippery slope back to smoking.

Many people argue that giving up smoking as well as anything with nicotine in it is extremely difficult and has a very high failure rate, while switching from smoking to smokeless tobacco products is less damaging for the lungs, easier to do, and involves consuming fewer toxins – a lesser of two evils.

The CDC expresses concern regarding the number of regular smokers who also use smokeless tobacco products.

In a communiqué, the CDC writes:

Recent tobacco industry advertising has encouraged cigarette smokers to use smokeless tobacco as an alternative product in locations where cigarette smoking is not permitted (e.g., smoke-free workplaces, airlines, and theaters). Continued surveillance of the co-use of tobacco products is needed to determine the effect of such marketing messages and the reasons for the high prevalence of smokeless tobacco use among cigarette smokers in some states. Antitobacco media messages, policies, and other interventions that prevent initiation and encourage cessation of both products also are needed, particularly in states with a high prevalence of smokeless tobacco use and cigarette smoking.

Source: CDC

“State-Specific Prevalence of Cigarette Smoking and Smokeless Tobacco Use Among Adults – United States, 2009”
Morbidity and Mortality Weekly Report (MMWR), CDC
November 5, 2010 / 59(43);1400-1406

Written by Christian Nordqvist