Understanding the growth in moist snuff: a mixed methods study

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DESCRIPTION (provided by applicant): While cigarette consumption in the U.S. continues to decline, consumption of moist snuff, the most popular form of smokeless tobacco (SLT) in the U.S. has increased 50% over the past decade. Moreover, the greatest increases occurred in the last five years. Factors believed to have contributed to the growth of moist snuff include price differentials by moist snuff brand and compared to cigarettes as well as aggressive industry marketing efforts exploiting clean indoor air laws and endorsing concurrent use with cigarettes. However, data on SLT use, including moist snuff, is collected infrequently, if at all, on most surveys and survey content rarely extends beyond current use. Hence, the tobacco control community has yet to observe trends in the widespread increase in SLT consumption noted in other data sources. This is despite the fact that the 1992 NCI monograph on SLT strongly recommended that all national tobacco surveys include questions on SLT use as well as questions to assess motivation to use, risk perceptions, and quit attempts. In the nearly two decades since the NCI monograph was published, the data needed to assess patterns of SLT use and monitor trends are still sorely lacking and the recent increases in use point to a great need. This exploratory research proposal describes a plan to address gaps in the knowledge base regarding use of moist snuff and smokeless tobacco. Accordingly, we will: 1) conduct focus groups to understand tobacco users' perceptions of moist snuff features and brands via focus groups, 2) develop and refine a survey instrument, which will undergo conduct cognitive testing, to assess the prevalence of moist snuff and the factors that are influencing its use including knowledge, attitudes, motivation, and risk perceptions, and 3) conduct a nationally representative population- based web survey of approximately 1560 male tobacco users, including a minimum of 460 current moist snuff users. Thus, the significance of this proposed research is its potential to generate a better understanding of moist snuff use as well as the attitudes and perceptions of its users which is vital to informing and directing tobacco control efforts.