Tobacco Use Among Rural High School Males and Associated Nicotine and Carcinogen Exposure


  1. Neal Benowitz, MD
  2. Stuart Gansky, MS, DrPH
Research Fields: 
Addiction and Cessation
Marketing and Prevention

Unlike smoking,conventional smokeless tobacco (ST) (moist snuff, known as dip and chewing tobacco) among US high school students is much higher among males (13%) than females (2%) and is especially high in rural areas.  In 2005, ST manufacturers spent over $250 million on marketing, including “new” ST products such as dissolvable films, compressed tobacco (e.g. tablets and toothpick-like sticks), and snus products, modeled after Swedish snus, a relatively low tobacco carcinogen and high-nicotine-content moist snuff.  Expanded promotion of conventional, new, and emerging ST products may encourage increased ST use and dual use with cigarettes among adolescent males.  No data exist on the addictive potential or nicotine and carcinogen exposure in adolescents using new ST products alone, or in dual use with cigarettes. The goal of this clustered longitudinal observational study of adolescent male athletes is to better understand cognitive and social determinants of their conventional and new ST product use, their dual use with cigarettes, and the impact of exposure to ST marketing and anti-tobacco messages on their risk and benefit perceptions, change in ST use and actual exposure to nicotine and carcinogens over time in rural high school males.