Prevalence data that are currently available indicate that smokeless tobacco use among youths in various parts of the United States is a significant and growing problem. Although relatively little is known about the factors that contribute to the initiation and maintenance of this behavior, previous research focusing on other substance use provides a valuable framework for both a study of smokeless tobacco use and the design of effective interventions for its prevention. The papers presented in this monograph address many of the gaps in our current knowledge and provide an accurate overview of research efforts in this area to date.