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Smokeless Tobacco Product Use in the United States						Print
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			Adult Smokeless Tobacco Product Use (National)Adult Smokeless Tobacco Product Use (By Region)Adult Smokeless Tobacco Product Use (State-Specific)Youth Smokeless Tobacco Product UseMultiple Product UseCessationMeasures to Protect the Public’s HealthReferences
		

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 Currently Used Smokeless Tobacco in 2021 1
About 2 in every 100 (2.1%) adults aged 18 or older reported current use  of smokeless tobacco products. This represents 5.2 million adults.
About 4 in every 100 (4.2%) men currently used smokeless tobacco.
Less than 1 in every 100 (0.2%) women currently used smokeless tobacco.
Among racial/ethnic groups, non-Hispanic White adults had the highest prevalence of smokeless tobacco use. Nearly 3 of every 100 (2.9%) non-Hispanic White adults currently used 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)1In 2021, the percentage of adults who reported current use of smokeless tobacco was highest among people living in the Midwest (3.2%) and the South (2.3%).
In 2021, the percentage of adults who reported current use of smokeless tobacco was lowest among people living in the Northeast (1.2%) and the West (1.6%).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 UseThe table below shows the percentage of high school students who were current users of smokeless tobacco in 2023.Group of teens sitting down.Smokeless Tobacco Product Use Among High School Students
High School Students in 20233
Current Use of Smokeless TobaccoOverall
1.5%Males
2.1%Females
–%White non-Hispanic
1.7%Hispanic
1.7%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 female high school students and Black non-Hispanic high school students who currently used smokeless tobacco in 2023 could not be calculated.Multiple Product UseIn 2021, nearly 2 of every 25 (7.9%) adults who reported using two or more tobacco products reported currently smoking cigarettes and using smokeless tobacco. Nearly 1 of every 10 (9.3%) of young adults (ages 18-24) who currently smoked cigarettes also reported current use of smokeless tobacco.5
In 2023, among high school students, 3.9% (610,000) indicated that they used multiple 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.CessationAccording 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.7Measures to Protect the Public’s HealthFamily 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.ReferencesCornelius ME, Loretan CG, Jamal A, et al. Tobacco Product Use Among Adults — United States, 2021. MMWR Morb Mortal Wkly Rep 2023;72:475–483.
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System: Prevalence and Trends Data. [accessed 2020 Aug 18].
Birdsey J, Cornelius M, Jamal A, et al. Tobacco Product Use Among U.S. Middle and High School Students — National Youth Tobacco Survey, 2023.MMWR Morb Mortal Wkly Rep 2023; 72(44);1173–1182.
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].
U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Centers for Disease Control and Prevention, 2020 [accessed 2020 Aug 18].
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.
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.
U.S. Food and Drug Administration. Tobacco Control Act. U.S. Department of Health and Human Services, U.S. Food and Drug Administration, 2015 [accessed 2016 Jul 18].Top of Page
							
					
							Last Reviewed:  November 2, 2023						Source: 	Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
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