Smokeless Tobacco Usage Among Teens from a Public Health Perspective
Erika Lindwall
MPH 500: Introduction to Public Health
Dr. Kelly Wheeler
June 22nd, 2014
INTRODUCTION
Using tobacco is detrimental to one’s health. This is a fact that has become commonplace
in recent years. Chronic tobacco usage has been linked to health problems like lung cancer,
esophageal cancer, oral cancer, heart disease, and atherosclerotic peripheral vascular disease
(hardening of the arteries) (CDC, 1999). The harmful effects of tobacco have been made known
to the public through ads, awareness programs in schools, and even labels on tobacco cartridges
themselves (“The Real Cost” campaign, “Truth” campaign). Because of this higher awareness,
there has been a decrease in cigarette smoking among adolescents and teens (Agaku et al., 2013).
However, the same cannot be said for usage of smokeless tobacco products (STPs) in the same
demographic. In fact, the rate of STP usage among teens in the United States has been
unchanged in the last decade. Recent surveys put the number of smokeless tobacco users among
teens to be between 5-11% (Agaku et al., 2013; American Cancer Society, 2013). That
percentage is more than 9 million adolescents in the United States.
Smokeless tobacco has become a widely socially acceptable substitute to cigarettes since
it is more discreet and does not pose any harm to others from second hand exposure (Agaku et
al., 2013). Furthermore, there may be a perceived lower risk associated with STPs This
perception is untrue. According to the American Cancer Society (2013), usage of the any STPs
(chewing tobacco, snuff, snus) carry increased risks for mouth, stomach, and pancreatic cancer,
heart disease, heart attack and stroke, mouth sores and tooth decay. Because of the risk factors
associated with tobacco use to a large amount of the population of American teens, smokeless
tobacco usage is a public health concern.
To understand the issue from a public health perspective, certain key subjects will be
analyzed. The first is epidemiology, where the risk factors and distribution of the condition will
be looked at in detail. Then the biomedical basis, biostatistics, and environmental and social
factors will be presented. Finally, a look into how the government is addressing the usage of
smokeless tobacco products among teens will show how the health of this demographic could
improve in the future.
BIOSTATISTICS
Biostatistics play an important role in understanding the extensive data collected on this
subject. By analyzing the biostatistics on STP use among teens, the health risks, vulnerable
demographics, and best ways to decrease the widespread use can be determined. In this section,
the statistics surrounding the usage of smokeless tobacco will be discussed in detail.
Much data about the health risks associated with smokeless tobacco has been collected
over the years. One of the major health risks is oral cancer. The biostatistics collected on the
prevalence of oral cancer have provided insightful information on cause and effect with
smokeless tobacco use. According to the Oral Cancer Foundation (2014), 43,250 Americans are
diagnosed with oral cancer every year, causing approximately 8,000 deaths yearly. Smokeless
tobacco is a known cause of oral cancer (American Cancer Society, 2013). In fact, there are 28
carcinogens found in smokeless tobacco products (WHO, 2007). STP users have an 80 percent
higher risk of oral cancer and a 60 percent higher risk of pancreatic and esophageal cancer.
These statistics illustrate the danger smokeless tobacco poses to those who use it.
Biostatics are also helpful in understanding what demographics are most at risk for using
STPs. According to an extensive study conducted by Boyd (1987), who surveyed 40,000
students, the populations at risk for smokeless tobacco use are mostly males of white, Native
American, and Hispanic decent. Rates of usage were lowest among black and Asian males as
well as females of white, black, and Hispanic decent. Rates of usage were higher among Native
American males and females. This is most likely due to cultural practices that involve tobacco
products (Boyd, 1987).
The findings of Boyd (1987) are supported by the findings of a more recent study. In an
article by Eaton et al. (2006), it was found that 13.6% of male high school students used STPs.
10.2% of those were white, 5.1% were Hispanic, and 1.7% were African American. These
finding show that the most vulnerable populations for smokeless tobacco usage among teens are
white and Hispanic males.
By using the biostatics that demonstrate the health concerns and populations at risk,
public health workers can develop targeted programs for education and research. Furthermore,
these statistics provide knowledge to the government on the severity of the current smokeless
tobacco situation and how many people are at risk of the health conditions associated with its
use. Armed with this knowledge, the government, in tandem with the public health field, can
devise a solution to the high usage of STP usage among teens.
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