NATIONAL HOUSEHOLD SURVEY ON DRUG ABUSE: smokeless tobacco tables

1997 National Household Survey on Drug Abuse

Discussion

More Americans have used tobacco than any other drug except alcohol. More than 80% of Americans in the civilian, noninstitutionalized population age 12 or older used alcohol at some time in their lifetime compared with 71% who had ever tried cigarettes. Nearly 30% of the population aged 12 or older reported being a current cigarette smoker. Many studies have confirmed the high prevalence of tobacco use, the rise in use by females after World War II, and the decline in use among those with more formal education.

Until recently, there was debate about whether tobacco should be considered a drug. In August 1996, however, the Food and Drug Administration (FDA) published its first comprehensive regulations restricting the sale and distribution of cigarettes and smokeless tobacco to children and adolescents. These regulations were based on the FDA's findings and conclusions that cigarettes and smokeless tobacco products are delivery devices for nicotine, an addictive drug.

The findings reported in this chapter show that in 1997, tobacco products were more likely to be used currently by males than by females, and by whites compared with blacks or Hispanics. In particular, current smokeless tobacco use occurred predominantly among white males in the young adult and middle adult age groups. Adults without a college education also were more likely than adults who have completed college to be current users of cigarettes or smokeless tobacco. However, these relationships can be complex. Among the total population aged 12 or older, for example, white males and females did not have significantly different rates of current cigarette use. Black and Hispanic females, however, were less likely than their male counterparts to be current smokers.

The relationship of tobacco use to gender, race/ethnicity, age, population density, region, education and employment status should be investigated carefully. As noted above, the interrelationships among several of these demographic characteristics are likely to be complex. For example, race/ethnicity is intricately associated with educational attainment and employment status. Similarly, apparent relationships between tobacco use and population density or region may be due to other demographic variations within these groups that also are related to tobacco use. No further cross-classification of demographic characteristics is provided in this report, except for age stratification, and tables examining drug use while simultaneously controlling for gender, race, and age. Multivariate analyses would permit a more thorough examination of the independent contributions of individual demographic characteristics in predicting current use of tobacco products.

Another noteworthy finding concerned the strong associations-and particularly for youths- between current use of cigarettes or cigars and use of other drugs in the past month. However, the presence of associations between cigarette use and use of other drugs should not be interpreted to mean that a causal relationship exists between use of tobacco products and subsequent use of other drugs. For example, even though 43% of youths and 28% of young adults who were current smokers also engaged in illicit drug use in the past month, the majority of youths and young adults who were current smokers did not.

Finally, the increasing prevalence of smoking among young adults aged 18 to 25 is alarming because it runs counter to long-term declines in rates of smoking by adults as a whole, both as indicated by the NHSDA (see Chapter 2) and by the National Health Interview Survey (NCHS, 1996). In particular, the 1997 NHSDA prevalence of current smoking among young adults was significantly higher than the rates in 1994 and 1995 (see Table 2.8). Furthermore, trend data from the 1996 NHSDA also indicated a significant increase between 1995 and 1996 in the prevalence of current smoking among young adults (OAS, 1998a, Table 2.8). These findings from the 1996 and 1997 NHSDAs indicate that the significant increase from 1995 to 1996 in the prevalence of current smoking among young adults was not an anomaly. Given that most people first use cigarettes in adolescence, these findings also suggest the need for heightened efforts to discourage the progression to regular smoking among young adults who have not yet started smoking regularly, and to encourage young adults who are regular smokers to quit.

Table 8.1 Percentage Reporting Cigarette Use in Their Lifetime, by Age Group and Demographic Characteristics: 1997


Demographic Characteristic	Age Group in Years				Total
Demographic Characteristic	12-17	18-25	26-34	35+	Total

Total	38.7	67.7	72.8	76.0	70.5

Gender
Male	39.0	72.2	76.8	82.5	75.3
Female	38.3	63.2	68.9	70.3	66.1
Race/Ethnicity¹
White, non-Hispanic	42.1	73.5	78.2	78.9	74.7
Black, non-Hispanic	28.2	54.6	63.0	72.2	61.9
Hispanic	33.0	55.7	58.5	62.3	56.2
Population Density
Large metro	35.3	65.9	72.1	75.1	69.4
Small metro	40.4	66.6	72.7	77.9	71.6
Nonmetro	41.8	72.9	74.9	74.6	70.9
Region
Northeast	32.7	64.8	72.2	74.5	69.1
North Central	42.9	72.6	78.6	74.9	71.9
South	39.3	69.3	71.4	77.3	71.3
West	37.7	61.6	69.2	76.2	69.0
Adult Education²
Less than high school	N/A	73.2	68.1	71.1	71.0
High school graduate	N/A	66.3	75.4	79.0	76.4
Some college	N/A	65.6	76.2	77.9	75.2
College graduate	N/A	68.5	68.9	74.2	72.8
Current Employment³
Full-time	N/A	73.3	73.3	78.7	76.7
Part-time	N/A	63.0	73.9	74.5	71.0
Unemployed	N/A	67.3	77.9	86.1	79.2
Other⁴	N/A	60.4	67.9	71.9	70.5

Note: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.

N/A: Not applicable.

¹ The category "other" for race/ethnicity is not included.
² Data on adult education are not applicable for youths aged 12 to 17. Total refers to adults aged 18 or older (unweighted n=16,661).
³ Data on current employment are not applicable for youths aged 12 to 17. Total refers to adults aged 18 or older (unweighted n=16,661).
⁴ Retired, disabled, homemaker, student, or "other."
Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 8.2 Percentage Reporting Cigarette Use in the Past Year, by Age Group and Demographic Characteristics: 1997


Demographic Characteristic	Age Group in Years				Total
Demographic Characteristic	12-17	18-25	26-34	35+	Total

Total	26.4	45.9	37.7	29.7	32.7

Gender
Male	25.7	52.2	40.0	30.8	34.6
Female	27.2	39.3	35.4	28.7	30.9
Race/Ethnicity¹
White, non-Hispanic	29.1	51.0	40.6	29.5	33.7
Black, non-Hispanic	18.2	33.9	31.3	36.0	32.5
Hispanic	20.8	35.8	31.8	30.6	30.4
Population Density
Large metro	23.6	42.1	37.0	27.0	30.4
Small metro	28.5	45.3	36.8	31.8	34.0
Nonmetro	28.2	53.3	40.9	31.1	35.0
Region
Northeast	21.2	40.6	36.4	28.0	30.0
North Central	30.3	51.7	41.8	31.3	35.7
South	26.6	47.5	37.8	31.5	34.1
West	26.1	40.4	33.8	26.4	29.4
Adult Education²
Less than high school	N/A	58.8	49.0	36.3	41.6
High school graduate	N/A	47.8	45.0	35.1	38.8
Some college	N/A	40.7	37.7	29.1	33.1
College graduate	N/A	29.6	23.1	17.9	19.7
Current Employment³
Full-time	N/A	48.2	37.3	31.7	35.2
Part-time	N/A	42.8	33.0	25.9	32.1
Unemployed	N/A	54.2	57.8	50.0	52.9
Other⁴	N/A	40.4	35.1	26.1	28.2

Note: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.

N/A: Not applicable.

Table 8.3 Percentage Reporting Cigarette Use in the Past Month, by Age Group and Demographic Characteristics: 1997


Demographic Characteristic	Age Group in Years				Total
Demographic Characteristic	12-17	18-25	26-34	35+	Total

Total	19.9	40.6	33.7	27.9	29.6

Gender
Male	19.1	46.5	35.5	28.8	31.2
Female	20.7	34.6	31.9	27.1	28.2
Race/Ethnicity¹
White, non-Hispanic	21.8	45.2	36.1	27.8	30.5
Black, non-Hispanic	14.9	30.2	28.4	33.8	29.8
Hispanic	16.0	30.9	28.7	28.9	27.4
Population Density
Large metro	17.4	36.4	32.9	25.1	27.2
Small metro	21.6	40.4	32.3	29.8	30.7
Nonmetro	21.6	48.5	38.0	29.8	32.4
Region
Northeast	16.1	37.1	32.3	27.2	28.0
North Central	22.4	44.5	37.3	28.4	31.5
South	20.6	43.8	34.6	29.6	31.4
West	19.1	33.1	29.2	24.9	26.0
Adult Education²
Less than high school	N/A	55.6	46.4	35.3	40.0
High school graduate	N/A	43.0	41.7	33.1	36.1
Some college	N/A	33.5	34.1	26.6	29.5
College graduate	N/A	24.9	17.0	16.4	17.1
Current Employment³
Full-time	N/A	43.6	33.2	29.9	32.4
Part-time	N/A	36.4	28.6	23.7	28.3
Unemployed	N/A	50.2	54.4	49.3	50.7
Other⁴	N/A	34.6	31.7	24.4	26.0

Note: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.

N/A: Not applicable.

Table 8.4 Percentage Reporting Cigarette Use in Their Lifetime, the Past Year, and the Past Month, by Age: 1997


		Time Period
Age Group in Years	(Unweighted n)	Lifetime	Past Year	Past Month

Total	(24,505)	70.5	32.7	29.6

12-17 Years	(7,844)	38.7	26.4	19.9
12-13	(2,506)	19.9	13.3	9.7
14-15	(2,750)	39.4	26.9	19.5
16-17	(2,588)	56.3	38.8	30.3
18-25 Years	(6,239)	67.7	45.9	40.6
18-20	(2,404)	65.0	47.7	41.1
21-25	(3,835)	69.6	44.6	40.3
26-34 Years	(4,387)	72.8	37.7	33.7
26-29	(1,875)	70.6	37.5	33.7
30-34	(2,512)	74.5	37.8	33.6
35+ Years	(6,035)	76.0	29.7	27.9
35-39	(1,232)	74.8	37.2	34.9
40-44	(1,081)	80.5	37.2	34.2
45-49	(911)	77.2	30.6	29.4
50+	(2,811)	74.8	24.7	23.4

Note: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.
Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 8.5 Percentage Reporting Cigarette Use in Their Lifetime, the Past Year, and the Past Month, by Age Group, Race/Ethnicity, and Gender: 1997


Race/Ethnicity¹ and Gender	Age Group in Years				Total
Race/Ethnicity¹ and Gender	12-17	18-25	26-34	35+	Total
(Unweighted n)
White, non-Hispanic male	(1,957)	(1,381)	(781)	(1,488)	(5,607)
Black, non-Hispanic male	(651)	(392)	(409)	(360)	(1,812)
Hispanic male	(1,025)	(826)	(531)	(497)	(2,879)

White, non-Hispanic female	(2,013)	(1,585)	(1,158)	(2,080)	(6,836)
Black, non-Hispanic female	(695)	(670)	(775)	(687)	(2,827)
Hispanic female	(1,061)	(1,037)	(603)	(679)	(3,380)
A. Used Cigarettes in Their Lifetime
White, non-Hispanic male	42.2	76.6	80.5	84.2	78.5
Black, non-Hispanic male	29.8	61.2	65.9	79.9	67.0
Hispanic male	34.2	63.9	71.5	73.0	65.5

White, non-Hispanic female	41.9	70.4	76.0	74.2	71.2
Black, non-Hispanic female	26.6	48.8	60.5	66.5	57.9
Hispanic female	31.7	46.8	43.7	52.1	46.6
B. Used Cigarettes in the Past Year
White, non-Hispanic male	27.8	55.7	41.7	29.8	34.6
Black, non-Hispanic male	19.3	43.5	31.5	42.0	37.0
Hispanic male	23.2	45.5	39.2	34.1	35.8

White, non-Hispanic female	30.6	46.2	39.5	29.3	32.8
Black, non-Hispanic female	17.1	25.4	31.2	31.5	28.8
Hispanic female	18.3	25.3	23.4	27.2	24.9
C. Used Cigarettes in the Past Month
White, non-Hispanic male	19.8	49.5	36.6	28.0	31.2
Black, non-Hispanic male	17.1	38.6	28.8	39.1	34.0
Hispanic male	18.8	40.4	35.2	32.2	32.5

White, non-Hispanic female	23.8	40.8	35.5	27.6	29.9
Black, non-Hispanic female	12.8	22.8	28.1	29.8	26.4
Hispanic female	13.1	20.6	21.3	25.8	22.2

Note: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.

¹ The category "other" for race/ethnicity is not included.

Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 8.6 Percentage Distribution of Levels of Past Month Cigarette Use, by Demographic Characteristics: 1997


		Past Month Use¹
Demographic Characteristic	(Unweighted n)	None	Less Than a Pack a Day	A Pack or More a Day

Total	(24,163)	71.1	16.2	12.7

Gender
Male	(10,677)	69.5	15.9	14.6
Female	(13,486)	72.6	16.4	11.0
Age Group in Years
12-17	(7,695)	81.6	16.3	2.1
18-25	(6,164)	59.9	29.2	11.0
26-34	(4,333)	66.8	20.5	12.7
35+	(5,971)	72.8	12.2	14.9
Race/Ethnicity²
White	(12,282)	70.2	14.7	15.1
Black	(4,569)	71.0	21.6	7.4
Hispanic	(6,167)	73.4	22.1	4.5
Population Density
Large metro	(12,803)	73.5	16.8	9.7
Small metro	(7,037)	70.0	15.6	14.4
Nonmetro	(4,323)	68.5	15.9	15.6
Region
Northeast	(2,880)	72.4	14.7	12.9
North Central	(3,209)	69.3	16.3	14.5
South	(7,432)	69.5	16.2	14.3
West	(10,642)	74.6	17.3	8.1
Adult Education³
Less than high school	(3,919)	60.7	20.8	18.5
High school graduate	(5,513)	64.6	18.3	17.1
Some college	(4,233)	70.9	17.5	11.6
College graduate	(2,803)	83.6	8.1	8.2
Current Employment⁴
Full-time	(8,743)	68.1	16.8	15.1
Part-time	(2,240)	72.1	17.7	10.1
Unemployed	(1,125)	49.6	26.6	23.8
Other⁵	(4,360)	75.0	13.1	11.9

Note 1: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.
Note 2: Only past month cigarette users who reported the number of cigarettes they smoked per day during the past 30 days are included in this table. Thus, the actual unweighted n's are smaller than appear in Table 1.1 because of offering patterns of nonresponse for the question on cigarettes per day.

¹ Less than a pack a day is defined as averaging 15 cigarettes or fewer per day in the past month. A pack a day or more is defined as averaging 16 or more cigarettes per day in the past month.
² The category "other" for race/ethnicity is not included.
³ Data on adult education are not applicable for youths aged 12 to 17. Total refers to adults aged 18 or older (unweighted n=16,468).
⁴ Data on current employment are not applicable for youths aged 12 to 17. Total refers to adults aged 18 or older (unweighted n=16,468).
⁵ Retired, disabled, homemaker, student, or "other."

Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 8.7 Percentage Reporting Use of Selected Drugs in the Past Month, by Age Group and Cigarette Use in the Past Month: 1997


Age Group in Years/ Drugs Used in the Past Month	Cigarette Use in the Past Month		Total
Age Group in Years/ Drugs Used in the Past Month	No¹	Yes	Total

Total
(Unweighted n)	(17,546)	(6,959)	(24,505)
Alcohol	45.4	65.5	51.4
Marijuana	1.8	13.0	5.1
Drugs other than marijuana	1.1	5.9	2.6
Nonmedical use of any psychotherapeutic²	0.7	2.5	1.2
Cocaine	0.2	1.9	0.7
Any illicit drug use³	2.7	15.2	6.4
12-17 Years
(Unweighted n)	(6,364)	(1,480)	(7,884)
Alcohol	10.7	59.8	20.5
Marijuana	2.4	37.4	9.4
Drugs other than marijuana	1.6	19.8	5.2
Nonmedical use of any psychotherapeutic²	0.8	7.4	2.1
Cocaine	0.1	4.5	1.0
Any illicit drug use³	3.6	42.8	11.4
18-25 Years
(Unweighted n)	(3,967)	(2,272)	(6,239)
Alcohol	45.2	77.8	58.4
Marijuana	4.5	25.0	12.8
Drugs other than marijuana	2.1	10.1	5.4
Nonmedical use of any psychotherapeutic²	1.3	4.0	2.4
Cocaine	0.2	2.8	1.2
Any illicit drug use³	5.7	27.7	14.7
26-34 Years
(Unweighted n)	(2,903)	(1,484)	(4,387)
Alcohol	54.8	70.9	60.2
Marijuana	2.5	12.8	6.0
Drugs other than marijuana	1.5	5.6	2.8
Nonmedical use of any psychotherapeutic²	0.6	3.1	1.4
Cocaine	0.3	1.9	0.9
Any illicit drug use³	3.6	14.8	7.4
35+ Years
(Unweighted n)	(4,312)	(1,723)	(6,035)
Alcohol	49.8	60.7	52.8
Marijuana	1.1	6.3	2.6
Drugs other than marijuana	0.8	3.0	1.4
Nonmedical use of any psychotherapeutic²	0.6	1.3	0.8
Cocaine	0.1	1.4	0.5
Any illicit drug use³	1.8	8.0	3.6

Note: Due to improved procedures implemented in 1994, these estimates are not comparable with those presented in NHSDA Main Findings prior to 1994.
¹ Includes respondents who reported never using cigarettes, as well as those who reported previous but not past month use.
² Nonmedical use of any prescription-type stimulant, sedative, tranquilizer, or analgesic; does not include over-the-counter drugs.
³ Use of marijuana or hashish, cocaine (including crack), inhalants, hallucinogens (including PCP and LSD), heroin, or nonmedical use of psychotherapeutics at least once.
Source: Office of Applied Studies, SAMHSA, National Household Survey on Drug Abuse, 1997.

Table 8.8 Percentage Reporting Smokeless Tobacco Use in Their Lifetime, by Age Group and Demographic Characteristics: 1997


Demographic Characteristic	Age Group in Years				Total
Demographic Characteristic	12-17	18-25	26-34	35+	Total

Total	9.6	23.8	23.9	15.5	17.3

Gender
Male	14.7	40.1	40.5	29.1	30.9
Female	4.2	7.3	7.5	3.6	4.7
Race/Ethnicity¹
White, non-Hispanic	12.2	31.4	30.1	16.9	20.1
Black, non-Hispanic	2.9	4.7	9.9	14.2	10.4
Hispanic	4.4	9.1	7.7	7.3	7.3
Population Density
Large metro	5.9	16.9	18.1	11.4	12.8
Small metro	10.3	25.1	28.6	17.0	19.2
Nonmetro	14.9	34.2	30.0	20.3	22.8
Region
Northeast	6.1	18.4	14.2	7.1	9.4
North Central	11.5	30.4	28.3	18.1	20.8
South	10.5	24.3