Risky Combo: Cigarettes and Other Tobacco Forms

Combining Cigarettes and Other Types of Tobacco Usage Linked to Higher Risk of Disease

By Bill Hendrick
WebMD Health News

Reviewed By Laura J. Martin, MD

Aug. 5, 2010 -- Men and young adults are most likely to smoke cigarettes in combination with using tobacco in other forms, the CDC says.

The CDC, in its Morbidity and Mortality Weekly Report for Aug. 6, reports that the use of other forms of tobacco is linked with higher nicotine addiction, the inability to kick the habit, and increases the odds that smokers will develop cancer, stroke, and heart disease.

The CDC's analysis of data from the 2008 Behavioral Risk Factor Surveillance System says many smokers use cigarettes in combination with other forms of tobacco, including smokeless tobacco, cigars, and pipes.

Other usage includes smoking bidis, a South Asian cigarette wrapped in a leaf, and kreteks, a cigarette made with cloves and other ingredients as well as tobacco.

Using such products, CDC says, is associated with youth and lower household incomes.

The analysis of the survey on adult smoking performed in 13 states reports that using cigarettes in combination with other forms of tobacco is more prevalent in men (4.4%) and young adults ages 18 to 24 (5.7%).

Use of multiple tobacco substances ranged from 1% in New Jersey to 3.7% in West Virginia.

"Every day, smoking kills more than 1,000 people and is the leading preventable cause of death," CDC Director Thomas R. Frieden, MD, MPH, says in a news release. "The more types of tobacco products people use, the greater their risk for many diseases caused by tobacco, such as cancer and heart disease."

State-by-State Tobacco Use

Researchers examined data from Delaware, Florida, Indiana, Kansas, Louisiana, Nebraska, New Jersey, North Carolina, Tennessee, Texas, West Virginia, Wisconsin, and Wyoming.

Here is a list of percentages of people who reported any tobacco use:

Delaware 23.8%

Florida 22.4%

Indiana 31.5%

Kansas 25.7%

Louisiana 25.3%

Nebraska 23.9%

New Jersey 18.4%

North Carolina 26.4%

Tennessee 30%

Texas 23.9%

West Virginia 35%

Wisconsin 25.8%

Wyoming 27.8%

The Morbidity and Mortality Weekly Report says the findings "highlight the need to increase expenditures to incorporate strategies that address smoking and other tobacco use in state and national" prevention and cessation efforts.

Other findings include:

  • Men were more likely to smoke than women, 31.5% to 18.3%.
  • 28.8% of people ages 18 to 24 reported any tobacco use, compared to 28.4% for those 25 to 44, 25.4% for those 45 to 64, and 12.8% for people 65 and older.
  • The percentage of smokers went down dramatically as incomes went up. For example, 32.5% of people with incomes under $15,000 reported any tobacco use, compared to 19.5% of those earning $75,000 or more.

The report says doctors and other health care providers should try to identify people who use any tobacco products and urge them to quit.


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SOURCES: News release, CDC.

Morbidity and Mortality Weekly Report, Aug.6, 2010; vol 59: pp 9933-9971.

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