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Use of Smokeless Tobacco Among Adolescents

Earl J. Berman; Paul M. Fischer, MD; John W. Richards Jr, MD
JAMA. 1986;255(23):3245. doi:10.1001/jama.1986.03370230051013.
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To the Editor.—  The recently published American Medical Association report, "Tobacco Product Liability," stated that there are no national data on teenage chewing tobacco use.1 However, there have been several regional reports of adolescent smokeless tobacco use based on self-report data. These have indicated use rates ranging between 10% and 40%.1-3 Recently, we conducted a study at two senior high schools, one urban and the other suburban, involving a total of 296 students and using a self-report questionnaire. It is known that the self-reporting of smoking is a sensitive subject for high school students and that significant underreporting is common.4 To overcome this, smoking researchers use validation techniques such as the "bogus pipeline."4,5 In this technique, students are told that their tobacco use responses will be validated by measuring saliva thiocyanate levels. Saliva specimens are then collected but not chemically processed. This is the first reported


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