| Demographic Group: | Students in grades 9–12. |
| Numerator: | Respondents in grades 9–12 who report having used smokeless tobacco products on >=1 days during the previous 30 days. |
| Denominator: | Respondents in grades 9–12 who report having or not having used smokeless tobacco products on >=1 days during the previous 30 days (excluding those who did not answer). |
| Measures of Frequency: | Annual prevalence with 95% confidence interval. |
| Time Period of Case Definition: | Previous 30 days. |
| Background: | In 2003, a total of 1.5% of students in grades 9–12 used chewing tobacco or snuff on >=1 of the previous 30 days. A greater percentage of male and white students used smokeless tobacco than did female and black students, respectively. |
| Significance: | Smokeless tobacco use is a cause of oral cancer and oral leukoplakia. Also, studies have determined it to be a risk factor for coronary heart disease, hypertension, and stomach cancer. Smokeless tobacco use established during adolescence might extend into adulthood and affect risk for chronic disease. In each of the 50 states and the District of Columbia, purchasing tobacco products is illegal for youth aged <18 years. |
| Limitations of Indicator: | Indicator does not convey the frequency of using smokeless tobacco or the lifetime and current amount of smokeless tobacco consumed. Each of these might affect the risk for chronic disease. |
| Data Resources: | Youth Risk Behavior Surveillance System (YRBSS) and Youth Tobacco Survey (YTS).
http://apps.nccd.cdc.gov/yrbss/ |
| Limitations of Data Resources: | As with all self-reported sample surveys, YRBSS and YTS data might be subject to systematic error resulting from noncoverage (e.g., no participation by certain schools), nonresponse (e.g., refusal to participate in the survey or to answer specific questions), or measurement (e.g., social desirability or recall bias). |
| Healthy People 2010 Objectives: | 27-2: Reduce tobacco use by adolescents. (27-2a is specific for tobacco products [previous month]; 27-2c is specific for spit tobacco [previous month].) |
