Trends in Smokeless Tobacco Use Among Working Adults
Trends in Smokeless Tobacco Use Among Working Adults
Smokeless tobacco causes cancers of the oral cavity, esophagus, and pancreas. CDC analyzed National Health Interview Survey (NHIS) data to estimate the proportion of U.S. working adults who used smokeless tobacco in 2005 and 2010, by industry and occupation. This report describes the results of that analysis, which showed no statistically significant change in the prevalence of smokeless tobacco use among workers from 2005 (2.7%) to 2010 (3.0%). In 2010, smokeless tobacco use was highest among adults aged 25–44 years (3.9%), males (5.6%), non-Hispanic whites (4.0%), those with no more than a high school education (3.9%), and those living in the South (3.9%). By industry, the prevalence of smokeless tobacco use ranged from 1.5% in education services to 18.8% in mining industries, and by occupation from 1.3% in office and administrative support to 10.8% in construction and extraction. These findings highlight opportunities for reducing the health and economic burdens of tobacco use among U.S. workers, especially those in certain industries (e.g., mining) and occupations (e.g., construction and extraction) where use of smokeless tobacco is especially common. CDC recommends best practices for comprehensive tobacco control programs, including effective employer interventions, such as providing employee health insurance coverage for proven cessation treatments, offering easily accessible help for those who want to quit, and establishing and enforcing tobacco-free workplace policies.
NHIS is an annual, nationally representative, in-person survey of the noninstitutionalized U.S. civilian population. Questions about cigarette smoking are directed to one randomly selected adult in each surveyed family. In 2005 and 2010, data on cigarette smoking were collected from 31,428 and 27,157 persons, respectively. The same participants responded to a supplemental questionnaire that contained questions regarding the use of smokeless tobacco (i.e., chewing tobacco and snuff).* The survey response rates for the adult core and supplemental questionnaire combined were 69.0% in 2005 and 60.8% in 2010.
Survey participants were considered currently working if, when asked about their employment status during the week before their interview, they responded, "working at a job or business," "with a job or business but not at work," or "working, but not for pay, at a family-owned job or business." Information on participants' current industry and occupation was coded by trained coders and grouped into 21 industry groups and 23 occupation groups. Current cigarette smokers were defined as respondents who reported having smoked ≥100 cigarettes during their lifetime and who reported currently smoking every day or some days. Current smokeless tobacco users were defined as respondents who reported having used chewing tobacco or snuff ≥20 times in their lifetime and who reported currently using chewing tobacco or snuff every day or some days. Dual users were defined as persons who were both current cigarette smokers and smokeless tobacco users. Sample weights were used to account for the complex sample design. Estimates with a relative standard error of ≥30% are not reported. Two-tailed t-tests were used to determine statistically significant differences between point estimates.
The estimated number of adults aged ≥18 years who were working during the week before the interview was 141 million in 2005 and 139 million in 2010. Current smokeless tobacco use prevalence among working adults did not significantly differ from 2005 (2.7%) to 2010 (3.0%)** (p=0.87). The prevalence of smokeless tobacco use among working adults was highest among those aged 18–24 years (3.6%) in 2005 and those aged 25–44 years (3.9%) in 2010, and among males (4.9% and 5.6%, in 2005 and 2010, respectively), non-Hispanic whites (3.5% and 4.0%), those with no more than a high school education (3.6% and 3.9%), and those living in the Midwest (3.8% and 3.3%) or South (3.1% and 3.9%) ( Table 1 ).
Current cigarette smoking prevalence among working adults aged ≥18 years was 22.2% in 2005 and 19.1% in 2010 (p<0.05). Among working adults who currently smoke cigarettes, the proportion who currently used smokeless tobacco (i.e., dual users) was 4.1% in 2005 and 4.2% in 2010 (p=0.55). In 2010, dual use was greatest among the following subgroups of working adult smokers: those aged 18–24 years (6.3%), males (7.3%), non-Hispanic whites (3.9%), those with no more than a high school education (4.5%), those with annual household income ≥$75,000 (4.8%), and those living in the Midwest (5.3%). Among adult workers, the average number of cigarettes smoked per day was significantly higher among dual users (15.5) compared with those who used cigarettes only (12.1) (p<0.05).
Reliable 2010 estimates of smokeless tobacco use were available for workers in 10 industry groups ( Table 2 ). Prevalence of smokeless tobacco use in 2010 was highest among workers in mining (18.8%), wholesale trade (8.9%), and construction (7.9%) industries. Reliable estimates of dual use among smoking workers were available only for construction (10.2%) and manufacturing (7.1%) industries.
Reliable 2010 estimates of smokeless tobacco use were available for workers in eight occupation groups ( Table 3 ). Prevalence of smokeless tobacco use in 2010 was highest among workers in construction and extraction (10.8%) and installation, maintenance, and repair (9.0%) occupations. No respondents in health-care support occupations reported smokeless tobacco use. Reliable estimates of dual use among smoking workers were available only for construction and extraction (14.5%) and production (5.7%) occupations.
*Additional information available at http://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm.
A total of 19,445 and 15,649 survey respondents were classified as currently working in 2005 and 2010, respectively.
Additional information available at ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2005/samadult_layout.pdf, http://www.census.gov/cps/files/occupation%20codes.pdf, and ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2008/naics_sectors_and_subsectors08.pdf.
Additional information available at http://www.cdc.gov/nchs/data/series/sr_10/sr10_256.pdf.
**The age-adjusted smokeless tobacco use in 2010 was 2.9%. The estimate was age-adjusted to the 2000 U.S. standard population using the age groups 18–24, 25–34, 35–44, 45–64, and ≥65 years following the Healthy People 2010 methodology (ftp://ftp.cdc.gov/pub/health_statistics/nchs/datasets/data2010/focusarea27/o2701b.pdf).
Additional information available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6038a2.htm?s_cid=mm6038a2_w.
Introduction
Smokeless tobacco causes cancers of the oral cavity, esophagus, and pancreas. CDC analyzed National Health Interview Survey (NHIS) data to estimate the proportion of U.S. working adults who used smokeless tobacco in 2005 and 2010, by industry and occupation. This report describes the results of that analysis, which showed no statistically significant change in the prevalence of smokeless tobacco use among workers from 2005 (2.7%) to 2010 (3.0%). In 2010, smokeless tobacco use was highest among adults aged 25–44 years (3.9%), males (5.6%), non-Hispanic whites (4.0%), those with no more than a high school education (3.9%), and those living in the South (3.9%). By industry, the prevalence of smokeless tobacco use ranged from 1.5% in education services to 18.8% in mining industries, and by occupation from 1.3% in office and administrative support to 10.8% in construction and extraction. These findings highlight opportunities for reducing the health and economic burdens of tobacco use among U.S. workers, especially those in certain industries (e.g., mining) and occupations (e.g., construction and extraction) where use of smokeless tobacco is especially common. CDC recommends best practices for comprehensive tobacco control programs, including effective employer interventions, such as providing employee health insurance coverage for proven cessation treatments, offering easily accessible help for those who want to quit, and establishing and enforcing tobacco-free workplace policies.
NHIS is an annual, nationally representative, in-person survey of the noninstitutionalized U.S. civilian population. Questions about cigarette smoking are directed to one randomly selected adult in each surveyed family. In 2005 and 2010, data on cigarette smoking were collected from 31,428 and 27,157 persons, respectively. The same participants responded to a supplemental questionnaire that contained questions regarding the use of smokeless tobacco (i.e., chewing tobacco and snuff).* The survey response rates for the adult core and supplemental questionnaire combined were 69.0% in 2005 and 60.8% in 2010.
Survey participants were considered currently working if, when asked about their employment status during the week before their interview, they responded, "working at a job or business," "with a job or business but not at work," or "working, but not for pay, at a family-owned job or business." Information on participants' current industry and occupation was coded by trained coders and grouped into 21 industry groups and 23 occupation groups. Current cigarette smokers were defined as respondents who reported having smoked ≥100 cigarettes during their lifetime and who reported currently smoking every day or some days. Current smokeless tobacco users were defined as respondents who reported having used chewing tobacco or snuff ≥20 times in their lifetime and who reported currently using chewing tobacco or snuff every day or some days. Dual users were defined as persons who were both current cigarette smokers and smokeless tobacco users. Sample weights were used to account for the complex sample design. Estimates with a relative standard error of ≥30% are not reported. Two-tailed t-tests were used to determine statistically significant differences between point estimates.
The estimated number of adults aged ≥18 years who were working during the week before the interview was 141 million in 2005 and 139 million in 2010. Current smokeless tobacco use prevalence among working adults did not significantly differ from 2005 (2.7%) to 2010 (3.0%)** (p=0.87). The prevalence of smokeless tobacco use among working adults was highest among those aged 18–24 years (3.6%) in 2005 and those aged 25–44 years (3.9%) in 2010, and among males (4.9% and 5.6%, in 2005 and 2010, respectively), non-Hispanic whites (3.5% and 4.0%), those with no more than a high school education (3.6% and 3.9%), and those living in the Midwest (3.8% and 3.3%) or South (3.1% and 3.9%) ( Table 1 ).
Current cigarette smoking prevalence among working adults aged ≥18 years was 22.2% in 2005 and 19.1% in 2010 (p<0.05). Among working adults who currently smoke cigarettes, the proportion who currently used smokeless tobacco (i.e., dual users) was 4.1% in 2005 and 4.2% in 2010 (p=0.55). In 2010, dual use was greatest among the following subgroups of working adult smokers: those aged 18–24 years (6.3%), males (7.3%), non-Hispanic whites (3.9%), those with no more than a high school education (4.5%), those with annual household income ≥$75,000 (4.8%), and those living in the Midwest (5.3%). Among adult workers, the average number of cigarettes smoked per day was significantly higher among dual users (15.5) compared with those who used cigarettes only (12.1) (p<0.05).
Reliable 2010 estimates of smokeless tobacco use were available for workers in 10 industry groups ( Table 2 ). Prevalence of smokeless tobacco use in 2010 was highest among workers in mining (18.8%), wholesale trade (8.9%), and construction (7.9%) industries. Reliable estimates of dual use among smoking workers were available only for construction (10.2%) and manufacturing (7.1%) industries.
Reliable 2010 estimates of smokeless tobacco use were available for workers in eight occupation groups ( Table 3 ). Prevalence of smokeless tobacco use in 2010 was highest among workers in construction and extraction (10.8%) and installation, maintenance, and repair (9.0%) occupations. No respondents in health-care support occupations reported smokeless tobacco use. Reliable estimates of dual use among smoking workers were available only for construction and extraction (14.5%) and production (5.7%) occupations.
*Additional information available at http://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm.
A total of 19,445 and 15,649 survey respondents were classified as currently working in 2005 and 2010, respectively.
Additional information available at ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2005/samadult_layout.pdf, http://www.census.gov/cps/files/occupation%20codes.pdf, and ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2008/naics_sectors_and_subsectors08.pdf.
Additional information available at http://www.cdc.gov/nchs/data/series/sr_10/sr10_256.pdf.
**The age-adjusted smokeless tobacco use in 2010 was 2.9%. The estimate was age-adjusted to the 2000 U.S. standard population using the age groups 18–24, 25–34, 35–44, 45–64, and ≥65 years following the Healthy People 2010 methodology (ftp://ftp.cdc.gov/pub/health_statistics/nchs/datasets/data2010/focusarea27/o2701b.pdf).
Additional information available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6038a2.htm?s_cid=mm6038a2_w.
Source...