Table of Contents
ISRN Public Health
Volume 2012, Article ID 304508, 7 pages
Research Article

Are Adolescent Cigarette Smokers Who Use Smokeless Tobacco More Likely to Continue Smoking in the Future than Cigarette-Only Smokers: Results from Waves I and II of the Adolescent Health Survey

1Centers for Disease Control and Prevention, Office on Smoking and Health, 4770 Buford Highway N.E., Mailstop K-50, Atlanta, GA 30341-3717, USA
2Research Triangle Institute International, Koger Center, Oxford Building, Suite 119, 2951 Flowers Road South, Atlanta, GA 30341-5533, USA

Received 15 December 2011; Accepted 4 January 2012

Academic Editors: C. I. Ardern, D. M. Ivanovic, and F. Montanaro

Copyright © 2012 Michelle M. O'Hegarty et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We explored whether dual use of smokeless and cigarettes among adolescents predicts continued smoking. Data came from Waves I (1994-95) and II (1996) of the National Longitudinal Study of Adolescent Health, using information from 3,284 Wave I current smokers. Multivariate models were used to assess whether use of smokeless tobacco at Wave I was associated with continuation of cigarette smoking at Wave II, controlling for possible confounders. The prevalence of current cigarette smoking at Wave 1 was 27.9%; among this group of adolescents and young adults, 14.5% also used smokeless tobacco. At Wave II, 73.6% of dual product users and 78.4% of cigarette-only users in Wave I reported continued smoking (OR=0.71 [95% CI 0.52–0.98]). Combined use of cigarette and smokeless tobacco does not appear to be related to continued smoking one year later. Longer-term followups are needed to determine the stability of this relationship for ≥1 year.