Perceived smokeless tobacco addiction among adolescents.

Although the prevalence and associated factors of smokeless tobacco (SLT) use are well-documented, there are no data on the prevalence and associated factors of SLT dependence-addiction. From a survey of 11,057 adolescents in the nonurban Southeastern United States, 3,726 reported having tried SLT, and 17% of those who had tried SLT perceived that they were addicted to it. Years of SLT use, frequency of use per day, and hours of exposure per day were strongly related to perceived addiction. Those using SLT for 1 year or longer had perceived addiction rates of 37% and were over 12 times more likely to report being addicted than were those using for less than 1 year. After controlling for level of SLT use, other factors including parental SLT use, perceived control over health, and racial-ethnic group also contributed minimally but significantly to reported SLT addiction.