New Research to Follow College Students’ Use of Smokeless Tobacco Products

October 26, 2009

WINSTON-SALEM, N.C. – Researchers at Wake Forest University Baptist Medical Center have received a $2.9 million federal grant to study smokeless tobacco use among college students and plan to follow them over three years of school.

Mark Wolfson, Ph.D., (Social Sciences and Health Policy), and John Spangler, M.D., (Family and Community Medicine), were awarded the grant in September. The grant is funded by the National Cancer Institute of the National Institutes of Health.

The goal of this study is to better understand smokeless tobacco use among college students and to measure their use over their college careers. The researchers will recruit a cohort of smokeless tobacco users and non-users from 10 colleges in North Carolina and follow this cohort using web-based surveys beginning in their freshman year. They will be looking at patterns of use of different products, including chewing tobacco, dry and moist snuff (including snus and other flavored products), and alternative tobacco products such as lozenges, strips, orbs and sticks.

“This is pretty innovative and was quite competitive, as only five other smokeless tobacco grants were funded nationally,” Spangler said. “There’s just not a lot of data about smokeless tobacco use in college students. Most studies look at smoking. No one has followed college students over time to see how their smokeless tobacco use changes over time.”

Spangler said this new study will build on research that Wolfson recently published about high secondhand smoke exposure in college students.

“One of the reasons we think this study is so important is that many new smokeless tobacco products are being marketed as a substitute for smoking,” Wolfson said. “We don’t know whether people toggle back and forth between different products or not.”

Spangler added that there is concern that these smokeless tobacco products might appeal to youth and could possibly move them toward cigarette use. Or, if they’re already smokers, the products are being touted as “harm reducing” and as a way to quit smoking. He doesn’t believe the claims, he said, adding that there is data to the contrary that suggests that even when a smoker uses smokeless tobacco products, they still continue to smoke. These products contain carcinogens and are still harmful to the mouth, teeth, gums, and throat, he said.

In their grant abstract, Spangler and Wolfson said that young adults ages 18-25, including both those in college and those who are not, have the highest prevalence of use of any adult age group. The manufacturing companies intentionally market their products to college students as a way for smokers to use nicotine in places where smoking is not permitted – which increasingly is becoming the norm on college campuses.

“The research field is very hungry for this kind of data on young people, and we think there will be a lot of interest in our results,” Wolfson said.

Wolfson is a professor and section head for the Section on Society and Health in the Department of Social Sciences and Health Policy of Wake Forest University School of Medicine. Spangler is a professor in the Department of Family and Community Medicine of the School of Medicine. Other researchers involved in the study include Erin Sutfin, Ph.D., Beth Reboussin, Ph.D., and Kim Wagoner, M.P.H., and the project manager for the study is Jessica Richardson, M.P.H., all of the School of Medicine.


Media Relations

Bonnie Davis:, 336-713-1597