Smokeless tobacco brand preference and brand switching among US adolescents and young adults

Correspondence to : Scott L Tornar, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-50, 4770 Buford Highway, NE, Atlanta, GA 30341-3724, USA Abstract Objectives -To describe the brand pre ference of young smokeless tobacco users in the US; to examine how this may change with duration, frequency, and intensity of use; and to examine self reported difficulty in quitting as a reason for use, and indicators of nicotine with drawal in relation to specific smokeless tobacco brands. Design Cross-sectional study from the 1993 Teenage Attitudes and Practices Survey (TAPS) and follow-up study from the 1989 TAPS. Setting Population surveys, US. Subjects Cross-sectional study : 282 subjects aged 10-22 years who used smokeless tobacco and bought their own, and did not smoke on more than five of the preceding 30 days; follow-up study: 83 subjects who used smokeless tobacco at baseline and follow up, reported buy ing their own smokeless tobacco at both surveys, and were not concurrent smokers. Results The moist snuff brands Skoal, Copenhagen, Kodiak, and Skoal Bandits accounted for 80% of the smokeless tobacco products purchased by young people. The likelihood of choosing Copen hagen increased with increasing dura tion, frequency, and intensity of smoke less tobacco use. Copenhagen and Kodiak users were more likely than users of Skoal Bandits or Skoal to report using smoke less tobacco because it was difficult to quit, and were more likely to report nicotine withdrawal symptoms. Among persons who used Skoal or Skoal Bandits at baseline, 50 % still used those brands at follow up and 31% had switched to Copenhagen; 83 % of persons who usually bought Copenhagen at baseline were still using it at follow up, and 17% had switched to Skoal or Skoal Bandits. Conclusions This study is consistent with the hypothesis that snuff users initially use brands with low nicotine dosage, and then switch to high nicotine dosage brands, particularly Copenhagen. Young smokeless tobacco users were dis proportionately likely to choose moist snuff, paralleling the marketing and ad vertising strategies of manufacturers. The higher rate of withdrawal symptoms and difficulty quitting reported among users of Copenhagen and Kodiak suggests that these brands may deliver nicotine more readily than Skoal or Skoal Bandits.