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Dual Tobacco use among Native American adults in southeastern North Carolina. 2001

J G Spangler, and R Michielutte, and R A Bell, and S Knick, and M B Dignan, and J H Summerson
Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA. jspangle@wfubmc.edu

OBJECTIVE While patterns of smokeless tobacco (ST) use and cigarette smoking are well documented, the epidemiology of simultaneous use of both tobacco products is less well studied, particularly among Native American populations. This study examines correlates of dual tobacco use among Lumbee Indian adults in southeastern North Carolina. METHODS A telephone survey among 400 adult Lumbee Indians in Pembroke, North Carolina, collected information on demographics, current tobacco use, amounts of tobacco used, and tobacco related attitudes. RESULTS Total of 241 (60.3%) individuals did not currently use tobacco, 104 (26%) currently smoked, 74 (18.5%) currently used ST, and 19 (4.8%) used both products. Thus, 19 of 104 (18.3%) current smokers and 19 of 74 (25.7%) current ST users reported dual tobacco use. Compared to exclusive users of either tobacco product, dual tobacco users were intermediate in age and frequency of church attendance, had lower levels of education, and were the highest proportion of subjects reporting no friends and few close relatives. There was no difference by gender or marital status by tobacco use categories. While exclusive cigarette smokers reported smoking more cigarettes per day than dual tobacco users, overall, dual tobacco users had higher estimated daily nicotine exposure levels. Logistic regression analysis showed that younger age and infrequent church attendance predicted exclusive cigarette smoking, while older age and less education predicted exclusive ST use. Dual tobacco use was predicted only by less education. CONCLUSIONS Simultaneous use of ST and cigarettes is comparatively more common among Lumbee Indian adults than the general population and has an epidemiology distinct from either exclusive cigarette smoking or ST use. These data are the first to explore social support as well as tobacco-related attitudes among dual tobacco users in a Native American population. Recognition of these patterns of dual tobacco use would be important in any future tobacco intervention among Lumbee Indian adults.

UI MeSH Term Description Entries
D007198 Indians, North American Members of indigenous North American populations with pre-colonial contact origins. Amerinds, North American,Indigenous North Americans,American Indian, North,American, Indigenous North,Amerind, North American,Indian, North American,Indigenous North American,North American Amerind,North American Amerinds,North American Indian,North American Indians,North American, Indigenous
D007722 Health Knowledge, Attitudes, Practice Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL). Knowledge, Attitudes, Practice
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009657 North Carolina State bounded on the north by Virginia, on the east and Southeast by the Atlantic Ocean, on the south by Georgia and South Carolina, and on the west by Tennessee.
D010947 Plants, Toxic Plants or plant parts which are harmful to man or other animals. Plants, Poisonous,Plant, Poisonous,Plant, Toxic,Poisonous Plant,Poisonous Plants,Toxic Plant,Toxic Plants
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000074606 Smoking Prevention Efforts directed at preventing SMOKING of TOBACCO and non-tobacco products. Anti-Smoking Campaign,Anti-Smoking Education,Anti Smoking Campaign,Anti Smoking Education,Anti-Smoking Campaigns,Anti-Smoking Educations,Campaign, Anti-Smoking,Campaigns, Anti-Smoking,Education, Anti-Smoking,Prevention, Smoking,Preventions, Smoking,Smoking Preventions
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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