Smokeless Tobacco Product Use in the United States

This fact sheet provides the latest data and information on how many people use smokeless and other tobacco products and what is being done to protect the public’s health from the harmful effects of smokeless tobacco use.

Smokeless tobacco is not a safe alternative to smoking. Learn more about who uses it and what measures are in place to protect the public’s health.

Adult Smokeless Product Tobacco Use (National)

Characteristics of Adults Who Were Current Smokeless Tobacco Users in 20181

  •  About 3 in every 100 (2.4%) adults aged 18 or older reported current use  of smokeless tobacco products. This represents 5.9 million adults.  Most adult smokeless tobacco users reported daily use.
    •  Nearly 5 in every 100 (4.7%) men were current users of smokeless tobacco.
    • Statistically reliable estimates of percent and number of women who were current users of smokeless tobacco in 2018 could not be calculated for 2018.
  • Among racial/ethnic groups, Non-Hispanic whites had the highest prevalence of smokeless tobacco use. Around 3 of every 100 (3.3%) Non-Hispanic whites were current users of smokeless tobacco.

NOTE:
In the list above, “current smokeless tobacco product use” means using chewing tobacco, snuff, dip, snus, or dissolvable tobacco at least once during their lifetime and, at the time of the survey, using at least one of these products “every day” or “some days.” The survey was conducted among persons aged 18 and older.

Adult Smokeless Tobacco Product Use (By Region)1

  • In 2018, the percentage of adults who reported current use of smokeless tobacco use was highest among people living in the Midwest (3.0%) and the South (2.9%).
  • In 2018, the percentage of adults who reported current use of smokeless tobacco use was lowest among people living in the Northeast (1.3%) and the West (1.7).

Adult Smokeless Tobacco Product Use (State-Specific)

  • In 2018, the percentage of adults who reported current smokeless tobacco use was highest in:2
    • Wyoming: nearly 9 in every 100 people (8.8%)
    • West Virginia: about 8 in every 100 people (8.3%)
    • Mississippi: about 7 in every 100 people (7.4%)
    • Kentucky: 7 in every 100 people (7.0%)
  • In 2018, the percentage of adults who reported current smokeless tobacco use was lowest in:2
    • New Jersey: about 1 in every 100 people (1.4%)
    • District of Columbia: nearly 2 in every 100 people (1.7%)
    • Rhode Island, Connecticut, California: nearly 2 in every 100 people (1.8%)

NOTE:
In the list above, “current smokeless tobacco” means using chewing tobacco, snuff, or snus every day or some days at the time of the survey.

Youth Smokeless Tobacco Product Use

Teens sitting in a group

The table below shows the percentage of high school students who were current users of smokeless tobacco in 2019.

Smokeless Tobacco Product Use Among High School Students
High School Students in 20193 Current Use of Smokeless Tobacco
Overall 4.8%
Males 7.5%
Females 1.8%
White non-Hispanic 6.5%
Hispanic 2.6%

NOTE:
In the table above—

  • Percentages represent approximately how many people in every 100 people use smokeless tobacco products. For example, 7.7% represents nearly 8 in every 100 people.
  • “Current use of smokeless tobacco” means using chewing tobacco, snuff, dip, snus, or dissolvable tobacco on 1 or more of the 30 days before participation in a survey about this topic.
  • A statistically reliable estimate of percent of Black non-Hispanic high school students who currently used smokeless tobacco in 2019 could not be calculated.

Multiple Product Use

  • In 2017, more than 1 of every 3 (3.5%) adults who were current cigarette smokers also reported current use of smokeless tobacco. Nearly 1 of every 10 (9.3%) of young adult (ages 18-24) current cigarette smokers also reported current use of smokeless tobacco.5
  • In 2019, more than 1 of every 10 (10.8%) high school students who reported current use of tobacco products indicated that they used two or more types of tobacco products.3
  • According to a 2016 report, use of both cigarettes and smokeless tobacco (dual use) was associated with switching to smokeless tobacco in an attempt to quit smoking cigarettes.6
    • Using smokeless tobacco products instead of cigarettes is not healthy, as smokeless tobacco can cause many negative health effects.
    • Using other tobacco products in addition to cigarettes (dual use) is not an effective way to safeguard your health.

Cessation

  • According to the 2017 National Health Interview Survey, 8.0% of adults were former users of smokeless tobacco.5
  • People who used only smokeless tobacco were less likely to try to quit than people who only smoked cigarettes.7

Measures to Protect the Public’s Health

Family Smoking Prevention and Tobacco Control Act

In 2009, the Family Smoking Prevention and Tobacco Control Act (FSPTCA) gave the U.S. Food and Drug Administration (FDA) the authority to regulate the manufacture, distribution, and marketing of tobacco products, including smokeless tobacco. Among other restrictions, the FSPTCA:8

  • Requires smokeless tobacco packages and advertisements to have larger and more visible labels that warn of health effects. Every package must include the following warning:
    • This product can cause mouth cancer.
    • This product can cause gum disease and tooth loss.
    • This product is not a safe alternative to cigarettes.
    • Smokeless tobacco is addictive.
  • Prohibits the sale of smokeless tobacco in vending machines, except in adult-only facilities.
  • Restricts tobacco marketing and sales to youth.
  • Prohibits tobacco companies from making reduced-harm claims like “light,” “low,” or “mild” without approval from FDA.
  • Requires tobacco companies to provide detailed information to FDA about the ingredients in their products.

References

  1. Creamer MR, Wang TW, Babb S, et al. Tobacco Product Use and Cessation Indicators Among Adults – United States, 2018. Morbidity and Mortality Weekly Report 2019, 68(45);1013-1019 [Accessed 2020 Aug 18]. .
  2. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System: Prevalence and Trends Data. [accessed 2020 Aug 18].
  3. Wang TW, Gentzke AS, Creamer MR et al. Tobacco Product Use and Associated Factors Among Middle and High School Students – United States, 2019. Morbidity and Mortality Weekly Report 2019;68(12), 1-22 [accessed 2020 Aug 18].
  4. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention, 2014 [accessed 2016 Jul 18].
  5. U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon Generalpdf iconexternal icon. Centers for Disease Control and Prevention, 2020 [accessed 2020 Aug 18].
  6. Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respiratory Medicine 2016;4(2):116–28.
  7. Kypriotakis G, Robinson JD, Green CE, Cinciripini PM. Patterns of tobacco product use and correlates among adults in the Population Assessment of Tobacco and Health (PATH) Study: a latent class analysis. Nicotine and Tobacco Research 2018;20(Suppl 1):S81–S87.
  8. U.S. Food and Drug Administration. Tobacco Control Actexternal icon. U.S. Department of Health and Human Services, U.S. Food and Drug Administration, 2015 [accessed 2016 Jul 18].
For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO

Media Inquiries: Contact CDC’s Office on Smoking and Health press line at 770-488-5493.