Trends in smokeless tobacco use among men in four states, 1988 through 1993

Objectives. Trends in smokeless tobacco use were examined for men in Indiana, Iowas, Montana, and West Virginia from 1988 through 1993. Methods. State survey data from the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Results. Demographic characteristics associated with smokeless tobacco use included age less than 35 years, a high school education or less, and rural residence. Overall, there was little change in smokeless tobacco use among men in these states (range = -0.4-0.4 percentage points annually); only West Virginia had a significant decline. Conclusions. Reasons for the overall lack of decline may include increased advertising an promotional expenditures or substitution of smokeless tobacco for cigarettes. increased prevention and cessation efforts are needed.