Dual tobacco use among Native American adults in southeastern North Carolina.

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Spangler, John G., Robert Michielutte, Ronny A. Bell, Stanley Knick, Mark B. Dignan, and John H. Summerson. “Dual tobacco use among Native American adults in southeastern North Carolina.” Preventive Medicine 32.6 (2001): 521-528.


The authors used a telephone survey of 400 adult Lumbee Indians living in Pembroke, N.C. to determine how many did not use tobacco at all (60.3%); smoked (26%); used smokeless tobacco (18.5%); or used both tobacco products (4.8%). The survey also gathered demographic data and information about respondents' attitudes toward tobacco use. Few previous studies of dual tobacco use had been conducted; and none of them looked at adults, were also population-based, and studied Native Americans.

This study had cooperation and support from both the Lumbee Tribal Council and the Lumbee Regional Development Association. Lengthy ethnographic interviews with twenty Lumbee community leaders were conducted. These were analyzed for themes and context by anthropologist Stanley Knick, and the results were used to develop the 41-item telephone survey.

Statistical analyses of the survey results are presented in Table 1 (type of tobacco use correlated with age, sex, education, marital status, number of close friends, number of close relatives, and frequency of church attendance), Table 2 (daily patterns of tobacco use correlated with type of tobacco used), and Table 3 (demographic predictors of cigarette smoking only, smokeless tobacco use only, and use of both products by logical regression analysis).

Findings of the statistical analyses included a high rate of dual tobacco users (4.8%), compared to other studies of adult dual tobacco users; dual users who are intermediate in age between younger cigarette smokers and older smokeless tobacco users; no predominance of males among dual users; and dual users having fewer close friends and relatives than the other tobacco users.

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