Double the Tobacco, Double the Risk

Cigarette and smokeless tobacco simultaneous use on the rise in some US states

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Faced with a booming tobacco industry and its long lineup of tobacco products to choose from, some tobacco users may think about choosing more than one — but they may need to think twice.

A new study found that the use of multiple tobacco products at the same time has risen in certain US states. The authors warned about the dangers of doubling up on these products.

"Cigarette smoking and the use of smokeless tobacco both cause substantial morbidity and premature mortality," wrote lead study author Kimberly Nguyen, MS, of the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health. "The [simultaneous] use of these products might increase dependence and the risk for tobacco-related disease and death."

According to the American Cancer Society (ACS), all tobacco products can be dangerous and addictive. When a person uses tobacco products, nicotine (the active ingredient in tobacco) is absorbed into bloodstream. The nicotine causes the brain to release adrenaline and creates a buzz of pleasure and energy. This cycle over and over may lead to addiction and make it hard to quit using tobacco products.

Nguyen and team looked at rates of cigarette and smokeless tobacco use — including products like chewing tobacco or snuff — across the US. The data came from the 2011 to 2013 Behavioral Risk Factor Surveillance System (a national telephone survey).

Nguyen and team found that rates of cigarette use went down significantly in 26 US states. However, smokeless tobacco use only went down in Ohio and Tennessee. It also went up in Louisiana, Montana, South Carolina and West Virginia.

These researchers also looked at survey participants' use of both cigarettes and smokeless tobacco at the same time. They found that the number of people who reported doubling up on tobacco products went up significantly in five states — Delaware, Idaho, Nevada, New Mexico and West Virginia.

"The use of more than one tobacco product is concerning because persons aged 18 years [or older] who use both cigarettes and smokeless tobacco have higher levels of nicotine dependence and are less likely to report planning to quit than those who exclusively smoke cigarettes," Nguyen and team wrote.

These researchers stressed that it is important to focus on on quitting tobacco products altogether, and not only reducing cigarette use.

"The findings in this report [back up] the importance of implementing proven [methods] for reducing the use of all tobacco products," Nguyen and team wrote.

This study was published online May 21 in the CDC's Morbidity and Mortality Weekly Report.

The authors disclosed no funding sources or conflicts of interest.

Review Date: 
May 21, 2015
Last Updated:
May 28, 2015