Tobacco Prevention Resources

At Prevention Resources (a division of NIMCO, Inc), we are proud to offer the largest variety of tobacco prevention resources on the market today.

Our tobacco use prevention resources are designed for all ages, with promotional items like tobacco prevention pamphlets and tobacco prevention phone grippers, as well as educational videos and games.

Smoking Prevention Education

We support the goals of the American Cancer Society, the American Heart Association and the American Lung Association. Nicotine addiction is a huge problem for all ages, but tobacco prevention for kids is especially important. We offer information and educational items on topics such as second-hand smoke, chewing or spit tobacco, vaping and more, along with many items for the Great American Smokeout.

We commend the many anti-tobacco groups across America who strive to achieve a Smokefree America. We offer a wide variety of customized smoking prevention education products, like vaping education anti-vaping and tobacco prevention banners suitable for all ages with many special items relating to the prevention of smoking for teens.

Tobacco Youth Prevention

Tobacco is a serious problem, and we are constantly researching and developing new products to provide up-to-date tobacco youth prevention resources to individuals and organizations that need to promote their specific message. Targeting youth tobacco prevention is especially key in the long-term prevention of smoking.

We take great pride in having partnered with many anti-smoking and anti-tobacco groups across America. We offer cutting-edge products with the most up-to-date research in all of our tobacco prevention promotional items.

Resources for Prevention of Tobacco Use

Knowledge is POWER in the prevention of tobacco use, and we offer the most power on the market today for tobacco and drug-free educational and promotional items.

Please use the content on this website as a tool to educate yourself and others about the dangers of smoking and tobacco use. On this site, you’ll find tobacco prevention facts as well as methods of preventing tobacco use among youth and adults in creative visuals like anti-tobacco posters.

Let NIMCO Help Your Tobacco Prevention Efforts

Please visit our retail site where you can explore many different tobacco prevention resources, including videos, DVDs, books, pamphlets, promotional giveaways, vaping awareness displays and many more. With a wealth of materials devoted to tobacco prevention and smoking prevention education, we hope to do our part to promote a Smokefree America.

Cigarette Smoking

• In 2007, 20% of high school students in the United States were current cigarette smokers—approximately 19% of females and 21% of males.₁
• Among racial and ethnic subgroups, approximately 23% of white, 17% of Hispanic, and 12% of African American high school students were current cigarette smokers in 2007.₁
• In 2006, approximately 6% of middle school students in this country were current cigarette smokers,2 with estimates of 6% for females and 6% for males.₂
• Among racial and ethnic subgroups, approximately 7% of white, 7% of Hispanic, 6% of African American, and 3% of Asian American middle school students were current cigarette smokers in 2006.₂
• Each day in the United States, approximately 3,900 young people between the ages of 12 and 17 years smoke their first cigarette.₃
• Each day in the United States, an estimated 1,000 young people between the ages of 12 and 17 years become daily cigarette smokers (i.e., defined as ever smoking every day for at least 30 days).₃

Other Tobacco Use

• More than 13% of high school students were current cigar smokers in 2007, with estimates higher for males (19%) than for females (8%).₄
• Nationally, an estimated 4% of all middle school students were current smokeless tobacco users in 2006, with estimates slightly higher for males (5%) than for females (3%).₂
• An estimated 13% of males in high school were current smokeless tobacco users in 2007.₄
• An estimated 4% of males in middle school were current smokeless tobacco users in 2006.₂
• In 2006, approximately 3 percent of high school students were current users of bidis; bidi use among males was (3%) and (2%) for females.₂
• Among middle school students, approximately 2% were bidi users, with estimates of 2% for males and 2% for females.₂

Factors Associated with Tobacco Use among Youth

• Some factors associated with youth tobacco use include low socioeconomic status, use and approval of tobacco use by peers or siblings, smoking by parents or guardians, accessibility, availability and price of tobacco products, a perception that tobacco use is normative, lack of parental support or involvement, low levels of academic achievement, lack of skills to resist influences to tobacco use, lower self-image or self-esteem, belief in functional benefits of tobacco use, and lack of self-efficacy to refuse offers of tobacco._5,6
• Tobacco use in adolescence is associated with many other health risk behaviors, including high-risk sexual behavior and use of alcohol or other drugs.₅

References

1. Centers for Disease Control and Prevention. Cigarette Use Among High School Students—United States, 1991–2007. Morbidity and Mortality Weekly Report [serial online]. 2008: 57(25):686–688 [accessed 2009 Jan 10].

2. Centers for Disease Control and Prevention. 2006 National Youth Tobacco Survey and Key Prevalence Indicators. (PDF–90 KB) [accessed 2009 Jan 10].

3. Substance Abuse and Mental Health Services Administration. Results from the 2008 National Survey on Drug Use and Health: Detailed Tables . (PDF–26.04 KB) Rockville (MD): Office of Applied Studies [accessed 2009 Sept 23].

4. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007. Morbidity and Mortality Surveillance Summary. 2008: 57(4):1–131 [accessed 2009 Jan 10].

5. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994 [accessed 2009 Jan 10].

6. U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000 [accessed 2009 Jan 10].

Tobacco and Athletic Performance

• Don’t get trapped. Nicotine in cigarettes, cigars, and spit tobacco is addictive.
• Nicotine narrows your blood vessels and puts added strain on your heart.
• Smoking can wreck lungs and reduce oxygen available for muscles used during sports.
• Smokers suffer shortness of breath (gasp!) almost 3 times more often than nonsmokers.
• Smokers run slower and can’t run as far, affecting overall athletic performance.
• Cigars and spit tobacco are NOT safe alternatives.

Tobacco and Personal Appearance

• Yuck! Tobacco smoke can make hair and clothes stink.
• Tobacco stains teeth and causes bad breath.
• Short-term use of spit tobacco can cause cracked lips, white spots, sores, and bleeding in the mouth.
• Surgery to remove oral cancers caused by tobacco use can lead to serious changes in the face. Sean Marcee, a high school star athlete who used spit tobacco, died of oral cancer when he was 19 years old.

So. . .

• Know the truth. Despite all the tobacco use on TV and in movies, music videos, billboards and magazines–most teens, adults, and athletes DON’T use tobacco.
• Make friends, develop athletic skills, control weight, be independent, be cool … play sports.
• Don ’t waste (burn) money on tobacco. Spend it on CDs, clothes, computer games, and movies.
• Get involved: make your team, school, and home tobacco-free; teach others; join community efforts to prevent tobacco use.
• Parents—Help Keep Your Kids Tobacco-Free

Kids who use tobacco may:

• Cough and have asthma attacks more often and develop respiratory problems, leading to more sick days, more doctor bills, and poorer athletic performance.
• Be more likely to use alcohol and other drugs such as cocaine and marijuana.
• Become addicted to tobacco and find it extremely hard to quit.
• Spit tobacco and cigars are not safe alternatives to cigarettes; low-tar and additive-free cigarettes are not safe either.
• Tobacco use is the single most preventable cause of death in the United States, causing heart disease, cancers, and strokes.

Take a Stand at Home—Early and Often

• Despite the impact of movies, music, and TV, parents can be the GREATEST INFLUENCE in their kids’ lives.
• Talk directly to children about the risks of tobacco use; if friends or relatives died from tobacco-related illnesses, let your kids know.
• If you use tobacco, you can still make a difference. Your best move, of course, is to try to quit. Meanwhile, don’t use tobacco in your children’s presence, don’t offer it to them, and don’t leave it where they can easily get it.
• Start the dialog about tobacco use at age 5 or 6 and continue through their high school years. Many kids start using tobacco by age 11, and many are addicted by age 14.
• Know if your kids’ friends use tobacco. Talk about ways to refuse tobacco.
• Discuss with kids the false glamorization of tobacco on billboards and in other media, such as movies, TV, and magazines.

Make a Difference in Your Community

• Vote with your pocketbook. Support businesses that don’t sell tobacco to kids. Frequent restaurants and other places that are tobacco-free.
• Be sure your schools and all school events (i.e., parties, sporting events, etc.) are tobacco-free.
• Partner with your local tobacco prevention programs. Call your local health department or your cancer, heart, or lung association to learn how you can get involved.

Coaches—You Can Influence Youth

• Smoking slows lung growth, decreases lung function, and reduces the oxygen available for muscles used in sports.
• Smokers suffer from shortness of breath almost 3 times more often than nonsmokers.
• Nicotine is addictive in ways like heroin and cocaine.
• Young people who do not start using tobacco by age 18 will most likely never start.
• Young people who use tobacco may be more likely to use alcohol and other drugs such as cocaine and marijuana.
• Spit tobacco and cigars are NOT safe alternatives to cigarettes; low-tar and additive-free tobacco products are not safe either.
• Tobacco use is the single most preventable cause of death in the United States, causing heart and lung diseases, cancers, and strokes.

Take a Stand—Early and Often

• Recognize your influence with young people. Don’t use tobacco around players. Remind them of the importance of being tobacco-free.
• When talking to players, remember they relate more to messages about the immediate effects of tobacco use (such as poorer athletic performance) than to its long-term health threats.
• Adopt and enforce a tobacco-free policy for players, coaches, and referees.
• Send a copy of the tobacco-free policy home for parents to review.
• Make all practices, games, and competitions tobacco-free—on the field and sidelines and in the stands.
• Announce and display tobacco-free messages at games.
• Consider partnering with your local tobacco prevention programs. Voice your support for tobacco-free schools, sports, and other community events.

Health Effects of Smoking

• Smoking harms nearly every organ of the body; causing many diseases and reducing the health of smokers in general.₁
• The adverse health effects from cigarette smoking account for an estimated 438,000 deaths, or nearly 1 of every 5 deaths, each year in the United States._2,3
• More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined._2,4.

Cancer

• Cancer is the second leading cause of death and was among the first diseases causually linked to smoking.₁
• Smoking causes about 90% of lung cancer deaths in men and almost 80% of lung cancer deaths in women. The risk of dying from lung cancer is more than 23 times higher among men who smoke cigarettes, and about 13 times higher among women who smoke cigarettes compared with never smokers.₁
• Smoking causes cancers of the bladder, oral cavity, pharynx, larynx (voice box), esophagus, cervix, kidney, lung, pancreas, and stomach, and causes acute myeloid leukemia.₁
• Rates of cancers related to cigarette smoking vary widely among members of racial/ethnic groups, but are generally highest in African-American men.₅

Cardiovascular Disease (Heart and Circulatory System)

• Smoking causes coronary heart disease, the leading cause of death in the United States.1 Cigarette smokers are 2–4 times more likely to develop coronary heart disease than nonsmokers.₆
• Cigarette smoking approximately doubles a person’s risk for stroke._7,8
• Cigarette smoking causes reduced circulation by narrowing the blood vessels (arteries). Smokers are more than 10 times as likely as nonsmokers to develop peripheral vascular disease.₉
• Smoking causes abdominal aortic aneurysm.₁

Respiratory Disease and Other Effects

• Cigarette smoking is associated with a tenfold increase in the risk of dying from chronic obstructive lung disease.7 About 90% of all deaths from chronic obstructive lung diseases are attributable to cigarette smoking.₁
• Cigarette smoking has many adverse reproductive and early childhood effects, including an increased risk for infertility, preterm delivery, stillbirth, low birth weight, and sudden infant death syndrome (SIDS).₁
• Postmenopausal women who smoke have lower bone density than women who never smoked. Women who smoke have an increased risk for hip fracture than never smokers.₁₀

References

1. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2006 Dec 5].

2. Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 1997–2001. Morbidity and Mortality Weekly Report [serial online]. 2002;51(14):300–303 [accessed 2006 Dec 5].

3. Centers for Disease Control and Prevention. Health United States, 2003, With Chartbook on Trends in the Health of Americans.(PDF–225 KB) Hyattsville, MD: CDC, National Center for Health Statistics; 2003 [accessed 2006 Dec 5].

4. McGinnis J, Foege WH. Actual Causes of Death in the United States. Journal of the American Medical Association 1993;270:2207–2212.

5. Novotny TE, Giovino GA. Tobacco Use. In: Brownson RC, Remington PL, Davis JR (eds). Chronic Disease Epidemiology and Control. Washington, DC: American Public Health Association; 1998;117–148 [accessed 2006 Dec 5].

6. U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking—25 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 1989. DHHS Pub. No. (CDC) 89–8411 [accessed 2006 Dec 5].

7. U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 1998 [accessed 2006 Dec 5].

8. Ockene IS, Miller NH. Cigarette Smoking, Cardiovascular Disease, and Stroke: A Statement for Healthcare Professionals From the American Heart Association. Journal of American Health Association. 1997;96(9):3243–3247 [accessed 2006 Dec 5].

9. Fielding JE, Husten CG, Eriksen MP. Tobacco: Health Effects and Control. In: Maxcy KF, Rosenau MJ, Last JM, Wallace RB, Doebbling BN (eds.). Public Health and Preventive Medicine. New York: McGraw-Hill;1998;817–845 [accessed 2006 Dec 5].

10. U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, CDC; 2001 [accessed 2006 Dec 5].

Tobacco & Death

• More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined._1,2

Tobacco use increases risk of death:

• Smoking cigarettes, pipes, or cigars increases the risk of dying from cancers of the lung, esophagus, larynx, and oral cavity._3,4
• Smokeless tobacco is a known cause of human cancer.₅
• In addition, the nicotine in smokeless tobacco may increase risk for sudden death from a condition (ventricular arrhythmias) where the heart does not beat properly and, as a result, the heart pumps little or no blood to the body’s organs.₅
• Tobacco use is the leading preventable cause of death in the United States.₆

Cigarettes and Death

• Cigarette smoking causes about 1 of every 5 deaths in the United States each year._1,6
• Cigarette smoking is estimated to cause the following:₁
  • 443,000 deaths per year (including deaths from secondhand smoke)
  • 49,400 deaths per year from secondhand smoke exposure
  • 269,655 deaths annually among men
  • 173,940 deaths annually among women
• Cigarette use causes premature death:
  • On average, adults who smoke cigarettes die 14 years earlier than nonsmokers.₇
  • Based on current cigarette smoking patterns, an estimated 25 million Americans who are alive today will die prematurely from smoking-related illnesses, including 5 million people younger than 18 years of age.₈
  • Secondhand Smoke and Death
• Exposure to secondhand smoke—sometimes called environmental tobacco smoke—causes nearly 50,000 deaths each year among adults in the United States.1
• Secondhand smoke causes 3,400 annual deaths from lung cancer.₁
• Secondhand smoke causes 46,000 annual deaths from heart disease._1,9,10

Increased Risk for Death Among Women

• Women who smoke increase their risk of dying from—
  • Bronchitis by more than 10 times_3,12
  • Emphysema by more than 10 times_3,12
  • Lung cancer by nearly 12 times₁₂
• Between 1960 and 1990, deaths from lung cancer among women increased by more than 500%, and lung cancer rates now exceed breast cancer rates among women:₁₃
  • By 1986, lung cancer rates surpassed breast cancer rates among white women.
  • By 1990, lung cancer rates surpassed breast cancer rates among black women.
• Smoking triples the risk of dying from heart disease among middle-aged women.₁₂

Increased Risk for Death Among Men

• Men who smoke increase their risk of dying from—
  • Bronchitis by nearly 10 times_3,12
  • Emphysema by nearly 10 times_3,12
  • Lung cancer by more than 22 times₁₂
  • Smoking triples the risk of dying from heart disease among middle-aged men.₁₂

References

1. Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8 [accessed 2009 Apr 8].

2. McGinnis J, Foege WH.. Actual Causes of Death in the United States. Journal of American Medical Association 1993;270:2207–12 [cited 2009 Apr 8].

3. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2009 Apr 9].

4. National Cancer Institute. Cigars: Health Effects and Trends (PDF–2.93 MB). Smoking and Tobacco Control Monograph No. 9. Bethesda (MD): U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 1998. NIH Publication No. 98-4302 [accessed 2009 Apr 8].

5. World Health Organization. Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines (PDF–3.18 MB). International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans Vol. 89. Lyon, France: World Health Organization, International Agency for Research on Cancer, 2007 [accessed 2009 Apr 27].

6. Centers for Disease Control and Prevention. Health, United States, 2008
(PDF–31.71 MB). Hyattsville (MD): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2006 [accessed 2009 Apr 10].

7. Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs—United States, 1995–1999. Morbidity and Mortality Weekly Report 2002;51(14):300–3 [accessed 2009 Apr 8]

8. Centers for Disease Control and Prevention. Perspectives in Disease Prevention and Health Promotion, Smoking-Attributable Mortality and Years of Potential Life Lost—United States, 1984. Morbidity and Mortality Weekly Report 1997;46:444–451 [accessed 2009 Apr 9].

9. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General . Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2009 Apr 13].

10. California Environmental Protection Agency. Environmental Tobacco Smoke: A Toxic Air Contaminant . Sacramento: California Environmental Protection Agency, Air Resources Board, 2006 [accessed 2009 Apr 13].

11. U.S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, 2001 [accessed 2009 Apr 9].

12. Novotny TE, Giovino GA. Tobacco Use. In: Brownson RC, Remington PL, Davis JR, editors. Chronic Disease Epidemiology and Control. Washington: American Public Health Association, 1998:117–48 [cited 2009 Apr 10].

13. Centers for Disease Control and Prevention. Mortality Trends for Selected Smoking-Related Cancers and Breast Cancer—United States, 1950–1990. Morbidity and Mortality Weekly Report 1993;42(44):857,863–6 [accessed 2009 Apr 13].

Definition of Secondhand Smoke

• Secondhand smoke, also known as environmental tobacco smoke, is a complex mixture of gases and particles that includes smoke from the burning cigarette, cigar, or pipe tip (sidestream smoke) and exhaled mainstream smoke.₁
• Secondhand smoke contains at least 250 chemicals known to be toxic, including more than 50 that can cause cancer.₁

Health Effects of Secondhand Smoke Exposure

• Secondhand smoke exposure causes heart disease and lung cancer in nonsmoking adults.₂
• Nonsmokers who are exposed to secondhand smoke at home or work increase their heart disease risk by 25–30% and their lung cancer risk by 20–30%.₂
• Breathing secondhand smoke has immediate harmful effects on the cardiovascular system that can increase the risk of heart attack. People who already have heart disease are at especially high risk.₂
• Secondhand smoke exposure causes respiratory symptoms in children and slows their lung growth.₂
• Secondhand smoke causes sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more frequent and severe asthma attacks in children.₂
• There is no risk-free level of secondhand smoke exposure. Even brief exposure can be dangerous.₂

Current Estimates of Secondhand Smoke Exposure

Exposure to nicotine and secondhand smoke is measured by testing the saliva, urine, or blood for the presence of a chemical called cotinine. Cotinine is a byproduct of nicotine metabolization, and tobacco is the only source of this marker.₂

From 1988–91 to 2001–02, the proportion of nonsmokers with detectable levels cotinine was halved (from 88% to 43%).₃

Over that same time period, cotinine levels in those who were exposed to secondhand smoke fell by 70%.₃

More than 126 million nonsmoking Americans continue to be exposed to secondhand smoke in homes, vehicles, workplaces, and public places.₂

Most exposure to tobacco smoke occurs in homes and workplaces.₂

Almost 60% of U.S. children aged 3–11 years—or almost 22 million children—are exposed to secondhand smoke.₂

About 25% of children aged 3–11 years live with at least one smoker, compared to only about 7% of nonsmoking adults.₂

The California Environmental Protection Agency estimates that secondhand smoke exposure causes approximately 3,400 lung cancer deaths and 22,700–69,600 heart disease deaths annually among adult nonsmokers in the United States.₄

Each year in the United States, secondhand smoke exposure is responsible for 150,000–300,000 new cases of bronchitis and pneumonia in children aged less than 18 months. This results in 7,500–15,000 hospitalizations, annually.₅

References

1. National Toxicology Program. 11th Report on Carcinogens, 2005. (PDF–219KB) Research Triangle Park, NC: U.S. Department of Health and Human Sciences, National Institute of Environmental Health Sciences, 2000 [accessed 2006 Sep 27].

2. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2006 Sep 27].

3. Pirkle JL, Bernert JT, Caudill SP, Sosnoff CS, Pechacek TF. Trends in the Exposure of Nonsmokers in the U.S. Population to Secondhand Smoke: 1988–2002. Environmental Health Perspectives. 2006;114(6):853–858 [accessed 2006 Sep 27].

4. California Environmental Protection Agency. Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. Final report, September 29, 2005, approved by Scientific Review Panel on June 24, 2005 [accessed 2006 Sep 27].

5. United States Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders.* Office of Research and Development, EPA/600/6-90/006F, Washington, D.C., December 1992 [accessed 2006 Sep 27]. * Also published as: National Institutes of Health. National Cancer Institute. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders: The Report of the U.S. Environmental Protection Agency. Smoking and Tobacco Control Monograph Number 4. NIH Publication No. 93-3605, Washington, D.C., August 1993.

Forms of Smokeless Tobacco

• The two main types of smokeless tobacco in the United States are chewing tobacco and snuff._1,2
• Chewing tobacco comes in the form of loose leaf, plug, or twist._2,3,4
• Snuff is finely ground tobacco that can be dry, moist, or packaged in sachets._2,3,4
• Although some forms of snuff can be used by sniffing or inhaling into the nose,2 most smokeless tobacco users place the product between their gum and cheek.3 Users suck or chew on the tobacco, and saliva can be spat out or swallowed._3,4
• The tobacco industry has also developed newer smokeless tobacco products such as lozenges, tablets, tabs, strips, and sticks._4,6

Health Effects

Smokeless Tobacco and Cancer

• Smokeless tobacco contains 28 cancer-causing agents (carcinogens)._2,4
• Smokeless tobacco is a known cause of human cancer; it increases the risk of developing cancer of the oral cavity and pancreas._4,7

Smokeless Tobacco and Oral Health

• Smokeless tobacco is also strongly associated with leukoplakia—a precancerous lesion of the soft tissue in the mouth that consists of a white patch or plaque that cannot be scraped off.₃
• Smokeles tobacco is associated with recession of the gums, gum disease, and tooth decay._3,6

Smokeless Tobacco and Reproductive Health

• Smokeless tobacco use during pregnancy increases the risks for preeclampsia (i.e., a condition that may include high blood pressure, fluid retention, and swelling), premature birth, and low birth weight.₄
• Smokeless tobacco use by men causes reduced sperm count and abnormal sperm cells.₄

Smokeless Tobacco and Nicotine Addiction

• Smokeless tobacco use can lead to nicotine addiction and dependence._2,4
• Adolescents who use smokeless tobacco are more likely to become cigarette smokers.₃
• Smokeless tobacco is a significant health risk and is not a safe substitute for smoking cigarettes.₂

Smokeless Tobacco Use in the United States

Smokeless tobacco use in the United States is higher among—

• Young white males
• American Indians/Alaska Natives
• People living in southern and north central states, and
• People who are employed in blue collar occupations or service/laborer jobs or who are unemployed₈

Adults and Smokeless Tobacco

• 3.3% of adults (aged 18 years and older) are current smokeless tobacco users.₉
• 6.5% of men are current smokeless tobacco users₉
• 0.4% of women are current smokeless tobacco users₉
• 7.0% of American Indian/Alaska Natives are current smokeless tobacco users₉
• 4.3% of whites are current smokeless tobacco users₉
• 1.3% of Hispanics are current smokeless tobacco users₉
• 0.7% of African Americans are current smokeless tobacco users₉
• 0.6% of Asian Americans are current smokeless tobacco users₉

High School Students and Smokeless Tobacco

• 7.9% of all high school students are current smokeless tobacco users₁₀
• 13.4% of male high school students are current smokeless tobacco users₁₀
• 2.3% of female high school students are current smokeless tobacco users₁₀
• 10.3% of white high school students are current smokeless tobacco users₁₀
• 4.7% of Hispanic high school students are current smokeless tobacco users₁₀
• 1.2% of African American high school students are current smokeless tobacco users₁₀

Middle School Students and Smokeless Tobacco

• 2.6% of middle school students are current smokeless tobacco users₁₁
• 4.1% of male middle school students are current smokeless tobacco users₁₁
• 1.2% of female middle school students are current smokeless tobacco users₁₁
• 3.4% of Hispanic middle school students are current smokeless tobacco users₁₁
• 2.8% of white middle school students are current smokeless tobacco users₁₁
• 2.0% of Asian middle school students are current smokeless tobacco users₁₁
• 1.7% of African-American middle school students are current smokeless tobacco users₁₁

NOTE: For all data tables above, “current” user is defined as using smokeless tobacco products on 1 or more of the 30 days preceding the survey.

Tobacco Industry Information

The five largest tobacco manufacturers have spent record amounts of money on smokeless tobacco advertising and promotions:₁

• $354.12 million in 2006
• $250.79 million in 2005

The two leading smokeless tobacco brands for users aged 12 years or older are—

• Skoal® (with 25% of the market share) and
• Copenhagen® (with 24% of the market share).₅

References

1. Federal Trade Commission. Smokeless Tobacco Report for the Year 2006.
(PDF–689 KB) Washington, DC: Federal Trade Commission; 2009 [accessed 2009 Aug 24].

2. National Cancer Institute. Smokeless Tobacco or Health: An International Perspective . Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 1992 [accessed 2009 Feb 9].

3. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994 [accessed 2009 Feb 9].

4. World Health Organization. Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines . (PDF–3.18 MB) International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans Vol. 89. Lyon, France: World Health Organization, 2007 [accessed 2009 April 27].

5. Maxwell JC. The Maxwell Report: The Smokeless Tobacco Industry in 2008. Richmond, VA: John C. Maxwell, Jr., April 2009 [cited 2009 May 13].

6. Campaign for Tobacco-Free Kids. Smokeless Tobacco and Kids. (PDF–144 KB) Washington: Campaign for Tobacco-Free Kids, 2009 [accessed 2009 Aug 24].

7. World Health Organization. Summaries and Evaluations: Tobacco Products, Smokeless (Group 1) . Lyon, France: World Health Organization, International Agency for Research on Cancer, 1998 [accessed 2009 Feb 9].

8. U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General . Bethesda, Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989 [accessed 2009 Feb 9].

9. Substance Abuse and Mental Health Services Administration. Results From the 2007 National Survey on Drug Use and Health: Detailed Tables . Rockville (MD): Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2007 [accessed 2009 Feb 9].

10. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007. (PDF–4.47 MB) Morbidity and Mortality Weekly Report 2007;57(SS-4):1–136 [accessed 2009 Feb 9].

11. Centers for Disease Control and Prevention. 2006 National Youth Tobacco Survey and Key Prevalence Indicators (PDF–167 KB) [accessed 2009 Apr 27].