Smokeless tobacco use and salivary cotinine concentration

Amy K. Ferketich, Alvin G. Wee, Jennifer Shultz, Mary Ellen Wewers

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


The objective of the current study was to examine demographic, tobacco-related, and psychosocial factors associated with cotinine concentration in a group of 256 male smokeless tobacco (ST) users living in the Ohio Appalachian region. Participants completed a survey that included questions on: 1) current and past tobacco use behaviors; 2) demographics; 3) tobacco dependence; 4) decisional balance; 5) health behaviors; and 6) perceived stress and depressive symptoms. Saliva samples were obtained for measurement of cotinine. The variables related to salivary cotinine concentration in the multiple regression model were age, marital status, occupation, quit attempts, years of ST use, and tobacco dependence score (adjusted R2 = 0.24). Among the 199 snuff only users, cotinine concentration was positively related to age, being divorced/widowed/separated, no quit attempts in the previous year, dependence score, and brand of snuff (adjusted R2 = 0.29). This is one of the largest studies to examine influences beyond topography on cotinine concentration in a group of rural ST users. These findings suggest that smokeless tobacco users and smokers share some similarities with respect to tobacco dependence.

Original languageEnglish (US)
Pages (from-to)2953-2962
Number of pages10
JournalAddictive Behaviors
Issue number12
StatePublished - Dec 2007
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by a grant from the National Institutes of Health (R01 DE13926). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.


  • Cotinine
  • Dependence
  • Smokeless tobacco


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