Differences in the Use of Smokeless Tobacco, Alcohol, and Co-Use Among U.S. High-School Students: Analysis of National Youth Risk Behavior Survey Data.

ABSTRACT:

Introduction

This study was aimed to examine the bidirectional relationships and patterns of concurrent smokeless tobacco and alcohol use among U.S. high-school students, investigating whether demographic characteristics and behavioral factors differentially predict concurrent versus single substance use of smokeless tobacco or alcohol (referred to as either-alone use in the remaining parts of this paper).

Methods

Analysis of nationally representative Youth Risk Behavior Survey data was perfomed, combining 3 cross-sectional surveys (2019, 2021, 2023) from 39,164 students in Grades 9-12. Logistic regression examined the bidirectional smokeless tobacco-alcohol associations, whereas multinomial models compared the characteristics of concurrent users, users of smokeless tobacco

SUBMITTER: Kostygina G 

PROVIDER: S-EPMC12765175 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature