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Agaku IT, Vardavas CI, Ayo-Yusuf OA, Alpert HR, Connolly GN. Temporal Trends in Smokeless Tobacco Use Among US Middle and High School Students, 2000-2011. JAMA. 2013;309(19):1992–1994. doi:10.1001/jama.2013.4412
Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Center for Global Tobacco Control, Harvard School of Public Health, Boston Massachusetts (Drs Agaku, Vardavas, Alpert, and Connolly) (email@example.com); and Department of Community Dentistry, University of Pretoria, Pretoria, South Africa (Dr Ayo-Yusuf).
To the Editor: Tobacco use remains the leading preventable cause of death and disease in the United States.1 Declines in smoking among youths were observed from the late 1990s, particularly after the Master Settlement Agreement in 1998.2 However, limited information exists on trends in smokeless tobacco use among US youths.
One study3 showed a decreasing trend in smokeless tobacco use during 1986 through 2003 before the increased availability of flavored products that may appeal to youths. This study analyzed recent trends in prevalence of smokeless tobacco use among youths using the 2000-2011 National Youth Tobacco Survey (NYTS).
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