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A survey of 1,180 sixth, ninth, and eleventh graders in three school districts in the State of Washington found that 34 per cent of male Native Americans, 24 per cent of female Native Americans, 20 per cent of male non-natives and 4 per cent of female non-natives are current users of smokeless tobacco products. In all areas and groups, the best predictor of whether an adolescent is a user is the use pattern of friends.

Smokeless tobacco use and attitudes toward smokeless tobacco among Native Americans and other adolescents in the northwest.