Ethnographic studies have suggested that blunt smokers represent a subculture of cannabis users whose drug use is moderated by social norms. The objective of this study was to compare rates of cannabis dependence/abuse and nicotine dependence between blunt and other cannabis smokers. The sample included adolescents and young adults (n = 4348) who reported some form of past-month cannabis use in the 2004 National Survey on Drug Use and Health. Compared to smokers who never used blunts, blunt smokers had significantly greater odds of being dependent on cannabis and tobacco. Associations with cannabis dependence/abuse remained statistically significant with adjustment for smoking frequency and demographic characteristics. These findings highlight the need for differentiating types of cannabis users in epidemiologic studies. The study's limitations are noted.

Introduction: Researchers have questioned whether the R.J. Reynolds Tobacco Company is marketing Camel Snus as a product for nontobacco users, smokeless-tobacco users, or cigarette smokers. The objective of this study was to examine advertisements of Camel Snus in print media to determine the most likely audience of intent. Methods: A content analysis was conducted among Camel Snus advertisements printed in newspaper and consumer magazines between July 2007 and August 2010. The advertisements (n = 83 distinct; N = 458 total) were identified from a comprehensive search of a proprietary database maintained by TNS Media Intelligence. Results: Results indicated that all advertisements, published between July 2007 and September 2009, were intended to promote a tobacco product for cigarette smokers. A shift in marketing strategy occurred from October 2009 to the present time with publication of the “Break Free” magazine advertisements, characterized by an ambiguous message that could conceivably appeal to any group, including nontobacco users (e.g., adolescents), smokeless-tobacco users, and/or cigarette smokers. However, an examination of the consumer magazines advertising Camel Snus indicated a demographically diverse readership in terms of gender, age, and education, suggesting that the advertisements are less likely to be intended for smokeless-tobacco users. Conclusions: These findings validate other reports and editorials, suggesting that Camel Snus was being marketed as a product for smokers at the time of the product's national debut. The recent shift to the “Break Free” marketing campaign may reflect an attempt to enhance the image of the Camel brand in order to attract a broader spectrum of consumers.

Introduction: The contentious debate over the promotion of Swedish snus, a form of moist snuff, as an alternative to cigarettes has often focused on the product's potential as a gateway to smoking. Findings from prospective studies in the United States have suggested that smokeless tobacco (SLT) is a significant predictor of smoking onset, before and after adjustment for baseline covariates. Use of conventional regression methods in these studies may have resulted in biased parameter estimates, arising from imbalanced covariate distributions in the users and nonusers of SLT. An alternative approach, which has been used widely in the econometric literature, matches exposure or treatment levels on the basis of the propensity score distribution.