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TU-1.2 Data Details

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TU-1.2 Reduce use of smokeless tobacco products by adults

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health Interview Survey (NHIS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent (age adjusted—see Comments)
Baseline (Year): 
2.2 (2015)
Target: 
0.2
Target-Setting Method: 
2 percentage point improvement
Target-Setting Method Justification: 
According to the International Agency for Research on Cancer and the National Cancer Institute, smokeless tobacco contains 28 cancer-causing agents (carcinogens). Furthermore, it is a known cause of human cancer, as it increases the risk of developing cancer of the oral cavity.
Numerator: 

Number of adults 18 years and older who report using smokeless tobacco products at least 20 times in their lifetime, and now use it every day or some days

Denominator: 

Number of adults aged 18 years and older

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2015 National Health Interview Survey:

    [NUMERATOR:]

    Smokeless tobacco products are placed in the mouth or nose and can include chewing tobacco, snuff, dip, snus (SNOOSE), or dissolvable tobacco. Have you ever used smokeless tobacco products EVEN ONE TIME?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    [if yes]Have you used smokeless tobacco products at least 20 times in your entire life?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    [if yes]Do you NOW use smokeless tobacco products every day, some days, or not at all?

    1. Every day
    2. Some days
    3. Not at all
    4. Refused
    5. Don't know
Data Collection Frequency: 
Periodic
Methodology Notes: 

    Persons are classified as using smokeless tobacco products if they answer “yes” to using smokless tobacco products, and they report using smokeless tobacco products “everyday” or “some days.”

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups:

    • Total: 18-24, 25-34, 35-44, 45-64, 65+
    • Sex: 18-24, 25-34, 35-44, 45-64, 65+
    • Race/Ethnicity: 18-24, 25-34, 35-44, 45-64, 65+
    • Educational Attainment: 25-34, 35-44, 45-64, 65+
    • Family Income: 18-24, 25-34, 35-44, 45-64, 65+
    • Family Type: 18-24, 25-34, 35-44, 45-64, 65+
    • Country of Birth: 18-24, 25-34, 35-44, 45-64, 65+
    • Disability Status: 18-24, 25-34, 35-44, 45-64, 65+
    • Geographic Location: 18-24, 25-34, 35-44, 45-64, 65+
    • Health Insurance Status: 18-24, 25-34, 35-44, 45-64
    • Marital Status: 18-24, 25-34, 35-44, 45-64, 65+
Changes Between HP2010 and HP2020: 
The title of this objective was revised from 'Reduce the use of spit tobacco' in Healthy People 2010 (objective 27-01b) to 'Reduce the use of smokeless tobacco products'. This modification resulted from the introduction of new tobacco products that no longer require the act of spitting. Although the objective language has changed, the measure used to assess progress toward the Healthy People 2020 objective target was identical to the Healthy People 2010 measure at the Healthy People 2020 launch. In 2017 the measure was revised due to changes to the survey questions and was no longer considered trendable with the previous measure. Please see revision history for more information.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
This measure was revised in 2017. At the launch of Healthy People 2020, the questions used about smokeless tobacco products were, "Have you used snuff such as Skoal, Skoal Bandits, or Copenhagen at least 20 times in your entire life?"/ "Do you now use snuff everyday, some days, or not at all? And, "Have you ever used chewing tobacco such as Redman, Levi Garrett, or Beechnut at least 20 times in your entire life?" /Do you now use chewing tobacco everyday, some days, or not at all?". Beginning with the 2015 data year, these questions were revised to: "Smokeless tobacco products are placed in the mouth or nose and can include chewing tobacco, snuff, dip, snus (SNOOSE), or dissolvable tobacco. Have you ever used smokeless tobacco products EVEN ONE TIME?" /"Have you used smokeless tobacco products at least 20 times in your entire life?" / "Do you NOW use smokeless tobacco products every day, some days, or not at all?". As a result of these changes, the numerator text was revised from: "Number of persons 18 years and older who report using snuff or chewing tobacco at least 20 times in their lifetime and now use it every day or some days" to "Number of adults 18 years and older who report using smokeless tobacco products at least 20 times in their lifetime, and now use it every day or some days". The baseline was revised from 2.3% in 2005 to 2.2% in 2015, and the target was adjusted from 0.3% to 0.2% based on the original target setting method of '2 percentage point improvement'.

References

Additional resources about the objective

  1. CDC. Cigarette smoking among adults---United States, 2007. MMWR 2008; 57:1221-1226.
  2. CDC. State-specific smoking-attributable mortality and years of potential life lost---United States, 2000—2004. MMWR 2009; 58:29-33.