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Smoking Cessation Health Center

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Smokeless Tobacco Rates on the Rise

Study Shows Many Smokers Are Also Using Smokeless Tobacco

Who’s Using Smokeless Tobacco continued...

Smoking prevalence was 6.4% in the U.S. Virgin Islands, 10.6% in Puerto Rico, and 24.1% in Guam.

Smoking prevalence for men was significantly higher than for women in 15 states, plus Guam and Puerto Rico. Smokeless tobacco use was highest in Wyoming at 9.1%, West Virginia at 8.5%, and Mississippi at 7.5%. It was lowest in California at 1.3% and Massachusetts and Rhode Island at 1.5%.

Among findings and conclusions in the report:

  • Smokeless tobacco use was most common among those aged 18 to 24.
  • Smokeless tobacco use decreased with higher educational attainment.
  • Among the 25% of states in which smoking prevalence was greatest, seven also had the highest numbers for smokeless tobacco use, Alabama, Alaska, Arkansas, Kentucky, Mississippi, Oklahoma, and West Virginia.
  • Doctors, dentists, and others in their offices should encourage patients to quit smoking and help them find ways to do so.

CDC Director Tom Frieden, MD, MPH, says it’s unfortunate that so many smokers also are using smokeless tobacco products, which “may keep some people from quitting tobacco altogether.” He says in a news release that anti-tobacco efforts need to be beefed up against all forms of use.

Tim McAfee, MD, MPH, director of the CDC’s Office on Smoking and Health, says in the news release that the new numbers showing smokeless tobacco use “are concerning” and that officials “need to fully put into practice effective strategies, such as strong state laws that protect nonsmokers from secondhand smoke, higher tobacco prices, aggressive ad campaigns that show the human impact of tobacco use and well-funded tobacco control programs, while stepping up our work to help people quit using all forms of tobacco.”

Tobacco Use State by State

Here’s a list of percentages of smokers who also use smokeless tobacco, by state, from lowest to highest.

State Percentage

Delaware 2.9

Washington, D.C. 3.0

Rhode Island 3.0

California 3.2

Maryland 3.6

Massachusetts 4.1

New Jersey 4.4

Maine 4.7

Louisiana 4.8

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