Use of smokeless tobacco among male adolescents: concurrent and prospective relationships

The concurrent and prospective correlates of the use of smokeless tobacco among 846 adolescent males were examined. There were 6- and 12-month follow-ups to the initial questionnaire. Substantial levels of tobacco, alcohol, and marijuana use were reported, with 21% reporting use of more than one drug in the last week. Daily smokeless tobacco users were more likely to initiate use of cigarettes, marijuana, and alcohol than were other males. In addition, the "having used" smokeless tobacco variable was related to increased use of cigarettes, marijuana, and alcohol at follow-up. Discriminant analysis of concurrent data identified peer use of smokeless tobacco and experience with cigarette smoking as the primary discriminating factors between males who had tried it and those who had not. Peer use of smokeless tobacco also discriminated between daily users and those who had tried it but had not gone on to become daily users. Thus peer influence seems to be an important factor not just in trial of smokeless tobacco but also in the development of a daily use pattern. Beginning use of smokeless tobacco was related to offers to use alcohol, cigarettes, and marijuana; peer use was the best predictor of continued daily use.