In general, as students progress through high school, students report more use of chewing tobacco by their friends

However, there has been a reported reduction in chewing tobacco use over the past several years with the exception of 10th grade students

and 12th grade students in 2006.

In sixth grade, most students indicate few  are using chewing tobacco. However, by eighth grade that has increased to 10%.

Alarmingly by grade 10 that percentage has increased to 40%, and in 2006, 50% of the students report their friends or using chewing tobacco

This indicates that major interventions are necessary to reduce chewing tobacco in Region five.