Background: Users of smokeless tobacco (chew or snuff) in the U.S. are viewed demographically as being homogeneous. Prior studies have demonstrated such homogeneity in national survey data but have not utilized latent-variable methods. The objective of this study was to determine whether a single group or underlying subgroups best characterize users of smokeless tobacco.
Methods: Men aged >17 years who had used smokeless tobacco in the past month (n=4583) were selected from the 2003, 2004, and 2005 National Surveys on Drug Use and Health. A latent-class analysis, conducted in 2008, was based on individual response patterns from six demographic variables and three items pertaining to the use of smokeless tobacco.
Results: Four latent classes were identified: older chew users (17.2%); younger poly-tobacco users (28.7%); skilled laborers with a high school diploma (27.5%); and educated professionals (26.6%). External validation of these classes indicated that older chew users and younger poly-tobacco users were more likely than the educated professionals to be former and current smokers, respectively.
Conclusions: While users of smokeless tobacco in the U.S. are predominantly white men, they are more heterogeneous with respect to education, occupation, and residency than commonly is perceived.