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      Regular smokeless tobacco use is not a reliable predictor of smoking onset when psychosocial predictors are included in the model

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      Nicotine & Tobacco Research

      Informa UK Limited

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          Abstract

          Tomar analyzed the CDC's Teenage Attitudes and Practices Survey (TAPS) and reported smokeless tobacco may act as a starter product for or gateway to cigarettes. Regular smokeless tobacco users at baseline were said to be 3.45 times more likely than never users of smokeless tobacco to become cigarette smokers after 4 years (95% CI=1.84-6.47). However, this analysis did not take into account well-known psychosocial predictors of smoking initiation. We reanalyzed TAPS to assess whether including psychosocial predictors of smoking affected the smokeless tobacco gateway effect. Experimenting with smoking, OR=2.09 (95% CI=1.51-2.90); below average school performance, OR=9.32 (95% CI=4.18-20.77); household members smoking, OR=1.49 (95% CI=1.13-1.95); frequent depressive symptoms, OR=2.19 (95% CI=1.25-3.84); fighting, OR=1.48 (95% CI=1.08-2.03); and motorcycle riding, OR=1.42 (95% CI=1.06-1.91) diminished the effect of both regular, OR=1.68 (95% CI=.83-3.41), and never regular smokeless tobacco use, OR=1.41 (95% CI=.96-2.05), to be statistically unreliable. Analyzing results from a sample of true never smokers (never a single puff) showed a similar pattern of results. Our results indicate that complex multivariate models are needed to evaluate recruitment to smoking and single factors that are important in that process. Tomar's analysis should not be used as reliable evidence that smokeless tobacco may be a starter product for cigarettes.

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          Author and article information

          Journal
          CNTR
          Nicotine & Tobacco Research
          Nicotine & Tobacco Research
          Informa UK Limited
          1462-2203
          1469-994X
          July 1 2003
          July 1 2003
          : 5
          : 4
          : 535-543
          Article
          10.1080/1462220031000118676
          12959791
          © 2003

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