Objective: Smokeless tobacco (SLT) use is associated with specific adverse health effects. Knowledge of student tobacco use, including SLT, may guide inquiry into other risky health behaviors, and provide opportunities for health education of students.

Design: An incentivized email invitation to complete a web-based survey was sent to students at 11 colleges and universities in North Carolina and Virginia.

Methods: In autumn 2010, emails were sent to all first-year students (n=29,536) at 11 colleges and universities in North Carolina and Virginia, inviting them to participate in a brief web-based survey to be used to establish a cohort for the parent study evaluating tobacco use over 4 years. Survey items elicited demographic characteristics, tobacco use and other health behaviors.

Results: A total of 10,520 (36%) students responded. Past 30 day smoking and SLT use were 12% and 3%, respectively. Logistic regression analysis revealed that male gender (Adjusted Odds Ratio [AOR] = 11.6, 95% Confidence Interval [CI] = 8.16–16.59); current smoking (AOR = 5.5, 95% CI = 4.21–7.10), ever use of alcoholic energy drinks (AOR = 4.8, 95% CI = 3.63–6.43), and ≥ 5 days vs. < 3 days of physical activity a week (AOR = 1.5, 95% CI = 1.07–2.01) predicted risk of past 30 day SLT use.

Conclusion: While SLT use is relatively uncommon, knowledge of significant correlations between student tobacco use, including SLT and other risky health behaviors, might guide clinicians’ inquiry and provide opportunities for health education of students.