Dual use of cigarettes and smokeless tobacco among South African adolescents

Objectives: To determine factors associated with dual use of tobacco products in a population of black South African adolescents. Methods: Data were obtained from a self-administered questionnaire completed by a representative sample of grade 8 students from 21 randomly selected secondary state schools in the Limpopo Province, South Africa (n=1878). Results: Of the respondents, 11.4% used smokeless tobacco (SLT), and 55.2% of SLT users also smoked cigarettes (dual users). Dual users were more likely to be vulnerable to depression, engage in binge drinking, smoke cannabis, and attend schools without rules against smoking. Conclusion: Dual tobacco use forms part of multiple-risk-taking behavior.