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Steven P. Schinke, PhD; Robert F. Schilling II, PhD
Columbia University New York

Lewayne D. Gilchrist, PhD; Marianne Rolland Ashby, MSW
Virginia Senechal University of Washington Seattle

JAMA. 1987;257(6):781.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Recent reports in JAMA and elsewhere are giving needed attention to the dangers and prevalence of smokeless tobacco use.^1-3 Perhaps most disquieting are patterns of snuff and chewing tobacco use among American adolescents.⁴ Those who begin using smokeless tobacco early in life not only are at risk for tissue damage from snuff and chewing tobacco products but also may later meet their nicotine dependence through cigarettes and other smoked tobacco products. As such, we have become interested in the use of smokeless tobacco among a US adolescent population with early and extreme patterns of smokeless tobacco use— Native American adolescents. Presented here are data on snuff and chewing tobacco use reported by 168 Native American adolescents from Alaska and Washington state.

The 77 females and 91 males, who had a mean age of 11.8 years, primarily resided on or near Indian reservations and Native villages. . . . [Full Text PDF of this Article]

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