Dual tobacco use among native American adults in southeastern North Carolina

Objective. While patterns of smokeless tobacco (ST) use and cigarette smoki ng are well documented, the epidemiology of simultaneous use of both tobacc o products is less well studied, particularly among Native American populat ions. This study examines correlates of dual tobacco use among Lumbee India n adults in southeastern North Carolina. Methods. A telephone survey among 400 adult Lumbee Indians in Pembroke, Nor th Carolina, collected information on demographics, current tobacco use, am ounts of tobacco used, and tobacco related attitudes. Results. A total of 241 (60.3%) individuals did not currently use tobacco, 104 (26%) currently smoked, 74 (18.5%) currently used ST, and 19 (4.8%) use d both products, Thus, 19 of 104 (18.3%) current smokers and 19 of 74 (25.7 %) current ST users reported dual tobacco use. Compared to exclusive users of either tobacco product, dual tobacco users were intermediate in age and frequency of church attendance, had lower levels of education, and were the highest proportion of subjects reporting no friends and few close relative s. There was no difference by gender or marital status by tobacco use categ ories. While exclusive cigarette smokers reported smoking more cigarettes p er day than dual tobacco users, overall, dual tobacco users had higher esti mated daily nicotine exposure levels. Logistic regression analysis showed t hat younger age and infrequent church attendance predicted exclusive cigare tte smoking, while older age and less education predicted exclusive ST use. Dual tobacco use was predicted only by less education. Conclusions. Simultaneous use of ST and cigarettes is comparatively more co mmon among Lumbee Indian adults than the general population and has an epid emiology distinct from either exclusive cigarette smoking or ST use, These data are the first to explore social support as well as tobacco-related att itudes among dual tobacco users in a Native American population. Recognitio n of these patterns of dual tobacco use would be important in any future to bacco intervention among Lumbee Indian adults. (C) 2001 American Health Fou ndation and Academic Press.