Does Chewing Tobacco Impact the Number of Chronic Health Problems in Adult Males Under Age 45 Years?

Introduction: Chewing tobacco has been suggested as a safer alternative to smoking cigarettes; however, controversy exists over the long-term health effects associated with it. This study assessed the relationship between tobacco use (none, chew only, smoke only, both) and number of chronic health problems in a representative sample of males age 18-44 from states with high rates of chewing tobacco use. Methods: This cross sectional analysis used data from the 2013 BRFSS for nonsmoking males age 18-44 in Mississippi, Montana, North Dakota, South Dakota, and West Virginia. Adjusted logistic regression analyses were conducted to determine the relationship between tobacco use (none, chew only, smoke only, both) and chronic health conditions while controlling for demographic and psychosocial factors. Results: Across states, 36-51% participants reported one or more chronic health problems. In adjusted analyses, having one or more chronic health problems was 1.49 times more likely for those who used chewing tobacco only, 1.34 times more likely for those who smoked, only and 1.95 times more likely for those who used both. Conclusion: Overall, use of chewing tobacco was related to chronic health problems in a representative sample of 18-44 year old males from states with high chewing tobacco rates. Although chewing tobacco use may not be as prevalent in the general population in other states, clinicians should be aware of the risks associated with chewing tobacco use