Untitled research work

To the Editor.— Recent reports inJAMAand elsewhere are giving needed attention to the dangers and prevalence of smokeless tobacco use.1-3Perhaps most disquieting are patterns of snuff and chewing tobacco use among American adolescents.4Those 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.