Tobacco use among high school athletes and nonathletes: Results of the 1997 Youth Risk Behavior Survey - Statistical Data Included

Adolescence, Winter, 2001 by Merrill J. Melnick, Kathleen E. Miller, Donald F. Sabo, Michael P. Farrell, Grace M. Barnes

High School Students and Smokeless ("Spit") Tobacco

The two major forms of smokeless tobacco--chewing tobacco (e.g., Redman, Levi Garrett, Beachnut) and dipping tobacco, also referred to as dipping snuff (e.g., Skoal, Skoal Bandits, Copenhagen)--pose major health risks, especially for their most frequent users, teenage males and young adult males. The documented health dangers associated with chronic smokeless tobacco use include cancer of the mouth, larynx, throat and esophagus, periodontal disease, nicotine addiction, coronary and peripheral vascular disease, delayed wound healing, reproductive disturbances, peptic ulcer disease, and decreased ability to taste (Hu et al., 1996; Riley et al., 1996; Walsh et al., 1994; Wichmann & Martin, 1994).

The Centers for Disease Control estimate that approximately 9.3% of male and 1.5% of female high school students use smokeless tobacco at least once a month (Koch, 1998). Among high school students who ever used smokeless tobacco, 73% did so by the 9th grade (Centers for Disease Control, 1994), suggesting that similar to cigarette smoking, the behavior begins in the pre-teen years. Tomar and Giovino (1998) estimate that in the United States, approximately 824,000 young people 11 to 19 years of age experiment with smokeless tobacco each year, and about 340,000 eventually become regular users.

Besides peer group influence (Ary, Lichtenstein, & Severson, 1987; Hill, Harrell, & McCormick, 1992), gender is a powerful predisposing factor to smokeless tobacco use. Research shows that the overwhelming number of smokeless tobacco users are males (Kegeles, Burleson, & Miozza, 1998; Lopez & Hamlin, 1995; New York State Education Department, 1997). This can be explained in part by the advertising industry's machismo image of the user, the well-publicized use of the product by celebrity male athletes, and the belief that chewing/dipping and winning are somehow related (Wichmann & Martin, 1994).

Researchers who have investigated the relationship between participation in organized sports and smokeless tobacco use have reported mixed results. While some have found that high school male athletes are more likely than nonathietes to be regular users (Hu et al., 1996; Tomar & Giovino, 1998), others have found no differences in smokeless tobacco use Baumert et al., 1998; Buckhalt et al., 1992; Rainey et al., 1996). The inconsistency can be explained by differences among subjects and operational definitions of smokeless tobacco use, the inclusion (or exclusion) of control variables, and variations in statistical analysis.

Far from an exclusively rural, blue-collar, Southern phenomenon (Horn et al., 2000), the use of smokeless tobacco among male adolescents is a growing national health concern. This substance is every bit as addictive as cigarette smoking, and in fact, the psychosocial predictors for smokeless tobacco use are not unlike those associated with cigarette smoking, namely, "... family structure, family conflicts, parental alcohol use, peer drug use, activities with peer (parties and sports), risk taking, stress, low achievement in school, and use of other substances" (Hu et al., 1996).