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Lund L, Bast LS, Rubæk M, Andersen S. Exploring factors associated with smokeless tobacco use among young people: A systematic scoping review. Drug Alcohol Depend 2022; 240:109627. [PMID: 36167002 DOI: 10.1016/j.drugalcdep.2022.109627] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE While smoking is declining among young people, smokeless tobacco use is increasing. Identifying who is using smokeless tobacco and why is essential in preventing smokeless tobacco use. This study aimed to comprehensively explore the factors of young people's use of smokeless tobacco in western countries and identify research gaps. METHODS We conducted a systematic scoping review of studies that examined factors associated with smokeless tobacco use among young people (ages 13-29) from western countries published between January 2011 and September 2021. Searches were conducted in CINAHL, Medline, and Scopus. Studies on adults, total tobacco use (i.e., did not differentiate between tobacco product types), dual and multiple uses of tobacco, and studies on smokeless tobacco cessation programs were excluded. RESULTS A total of 160 studies were included in this scoping review. The studies were primarily undertaken in the US and the Scandinavian countries, and the majority explored smokeless tobacco use without distinguishing between the specific types. Smokeless tobacco users were more likely to be male, non-Hispanic white, engaging in physical activity, and using other substances, including cigarettes and alcohol. The role of friends and family were identified as critical factors that were related to the use of smokeless tobacco. CONCLUSIONS This scoping review suggests that preventative measures against smokeless tobacco use should focus on peer and family members' roles and that these measures may benefit from targeting males. Additional research, including systematic reviews on this area to validate the identified associated factors, would improve the understanding of smokeless tobacco use.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Mette Rubæk
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
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Harlow AF, Vogel EA, Tackett AP, Cho J, Han DH, Wong M, Cockburn MG, Sussman SY, Unger JB, Leventhal AM, Barrington-Trimis JL. Adolescent Use of Flavored Non-Tobacco Oral Nicotine Products. Pediatrics 2022; 150:188734. [PMID: 35934731 PMCID: PMC9994602 DOI: 10.1542/peds.2022-056586] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Flavored non-tobacco oral nicotine products (eg, nicotine pouches and nontherapeutic nicotine gum, lozenges, tablets, gummies), are increasingly marketed in the United States. Prevalence of non-tobacco oral nicotine product use among adolescents is unknown. METHODS We calculated prevalence of ever and past 6-month use of nicotine pouches, other non-tobacco oral nicotine products (ie, gum, lozenges, tablets, and/or gummies), e-cigarettes, cigarettes, hookah or waterpipe, cigars, cigarillos, and snus among high school students in Southern California between September and December 2021. Generalized linear mixed models tested associations of sociodemographic factors and tobacco-product use with use of any non-tobacco oral nicotine product. RESULTS Among the sample (n = 3516), prevalence was highest for e-cigarettes (ever: 9.6%, past 6-month: 5.5%), followed by non-tobacco oral nicotine products (ever: 3.4%, past 6-month: 1.7%), and <1% for other products. Ever users of combustible tobacco (adjusted odds ratio [aOR] = 77.6; 95% confidence interval [CI] = 39.7-152) and ever users of noncombustible tobacco (aOR = 40.4; 95% CI= 24.3-67.0) had higher odds of ever using non-tobacco oral nicotine products, compared to never users of combustible and noncombustible tobacco. Use of any non-tobacco oral nicotine product was greater for Hispanic (versus all other races/ethnicities except Asian, aOR = 2.58; 95% CI = 1.36-4.87), sexual minority (versus heterosexual, aOR=1.63; 95% CI = 1.03-2.57), gender minority (versus male, aOR = 2.83; 95% CI = 1.29-6.19), and female (versus male, aOR=1.92, 95% CI = 1.20-3.06) participants. CONCLUSIONS Non-tobacco oral nicotine products were the second most prevalent nicotine product used by adolescents. They were disproportionately used by certain racial or ethnic, sexual, or gender minority groups, and those with a history of nicotine use. Adolescent non-tobacco oral nicotine product use surveillance should be a public health priority.
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Affiliation(s)
- Alyssa F Harlow
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Erin A Vogel
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Alayna P Tackett
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Junhan Cho
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Dae-Hee Han
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Melissa Wong
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine
| | - Myles G Cockburn
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine.,Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Steve Y Sussman
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Jennifer B Unger
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Adam M Leventhal
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
| | - Jessica L Barrington-Trimis
- USC Institute for Addiction Science.,Department of Population and Public Health Sciences, Keck School of Medicine.,USC Norris Comprehensive Cancer Center, Keck School of Medicine
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Skogen JC, Sivertsen B, Hysing M, Heradstveit O, Bøe T. Economic Circumstances in Childhood and Subsequent Substance Use in Adolescence - A Latent Class Analysis: The youth@hordaland Study. Front Psychol 2019; 10:1115. [PMID: 31139128 PMCID: PMC6527884 DOI: 10.3389/fpsyg.2019.01115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/29/2019] [Indexed: 12/22/2022] Open
Abstract
The aim of the present study was to investigate the association between longitudinal registry-based data on family income during childhood and self-reported substance use in adolescence, including potential alcohol- or drug problems. Data from the Norwegian population-based youth@hordaland-survey was employed, and the analyzed included n = 8,983 adolescents aged 16–19 years. This information was linked to registry-based information about childhood family income for seven consecutive years prior to adolescents’ participation in the youth@hordaland-survey. Latent class analyses (LCA) were used to examine associations between patterns of family economic circumstances in childhood and subsequent substance use in adolescence. Based on the LCA, we identified four distinct patterns of family economic circumstances: a ‘never poor’ (89.3%) group, followed by two groups characterized by moving in (3.0%) or out (4.6%) of poverty, and a final ‘chronically poor’ (3.1%) group. Several findings were of interest: the chronically poor reported less daily snus use, fewer had tried alcohol, were less likely to report frequent intoxication, and less prone to have potential alcohol- or drug-related problems compared to all other groups. They were also less likely to have tried any illicit drug compared to those moving in or out of poverty. Finally, the chronically poor reported more daily smoking than the never poor group, but less daily smoking than the moving out of poverty group. The never poor group was less likely to have tried any illicit drugs compared to the groups moving into or out of poverty, and less likely to smoke daily compared to the moving out of poverty group. In other words, the present study somewhat surprisingly suggested lower substance use among the chronically poor adolescents compared to other adolescents on several of the measures of substance use.
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Affiliation(s)
- Jens Christoffer Skogen
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Ove Heradstveit
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Batanova MD, Loukas A, Velazquez CE, Brown WJ. Differences between Dual Users of Cigarettes and Snus and Other Tobacco Users in the United States: An Examination of Adolescent Males. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015. [DOI: 10.1080/1067828x.2013.829012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Choi K, Fabian LE, Brock B, Engman KH, Jansen J, Forster JL. Availability of snus and its sale to minors in a large Minnesota city. Tob Control 2014; 23:449-51. [PMID: 23303287 PMCID: PMC4039575 DOI: 10.1136/tobaccocontrol-2012-050719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Previous studies examining tobacco retailers' compliance with youth tobacco access policies have mostly evaluated retailers' likelihood of selling cigarettes to minors, and none have evaluated the likelihood of selling snus (a new smokeless tobacco product) to minors. We assessed the availability of snus and the likelihood of selling snus to adolescents in tobacco retailers in a large city in Minnesota. METHODS We randomly selected 71 eligible retailers located in a large city in Minnesota, and assessed the availability of snus through Camel snus retailer listings and phone inquiry. Purchase attempts by an underage buyer were used to assess the likelihood of selling snus to minors. χ2 tests were used to examine the store and neighbourhood characteristics associated with availability of snus. RESULTS We found that 31 retailers (43.7%) carried snus in the store, and 4 (12.9%) sold snus to the underage buyer. Retailers who sold gasoline were more likely to carry snus in the store (p<0.01). Neighbourhood demographic characteristics were not associated with availability of snus (p>0.10). CONCLUSIONS Prevalence of snus sales to minors appeared to be higher than that of cigarette sales to minors according to the 2011 Synar report. Futures studies are needed to determine whether tobacco retailers are more likely to sell snus than cigarettes to minors. Interventions such as public and retailer policies are needed to reduce the likelihood of tobacco retailers selling snus to minors.
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Affiliation(s)
- Kelvin Choi
- Division of Epidemiology and Community Health, University of Minnesota, West Bank Office Building Suite 300, 1300 South Second Street, MN 55454, Phone: 612-626-1799, Fax: 612-624-0315
| | - Lindsey E.A. Fabian
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Betsy Brock
- Association for Nonsmokers – Minnesota, St. Paul, MN, USA
| | | | - Jim Jansen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jean L. Forster
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
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Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Grucza RA, Bierut LJ. Youth tobacco use type and associations with substance use disorders. Addiction 2014; 109:1371-80. [PMID: 24717237 PMCID: PMC4107060 DOI: 10.1111/add.12567] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/17/2014] [Accepted: 03/28/2014] [Indexed: 11/29/2022]
Abstract
AIMS To examine the associations between youth poly-tobacco use and substance use disorders. DESIGN Analysis of data from the 2007-11 US National Survey on Drug Use and Health. SETTING Randomly selected, household-dwelling adolescents from the non-institutionalized, civilian population of the United States. PARTICIPANTS A total of 91 152 adolescents (aged 12-17 years). METHODS Logistic regression models were used to examine the associations between type of tobacco user (non-user, users of alternative tobacco products only, users of cigarettes only and users of cigarettes plus alternative tobacco products) with past year alcohol, marijuana or other illicit drug use disorders, adjusting for demographic and social variables. FINDINGS Compared with non-users of tobacco, the greatest risk for substance use disorders was among users of cigarettes plus alternative tobacco products [alcohol disorder adjusted odds ratio (aOR) = 18.3, 95% confidence interval (CI) = 16.2-20.6; marijuana disorder aOR = 37.2, 95% CI = 32.5-42.7; other drug disorder aOR = 18.4, 95% CI = 15.4-21.8], followed by users of cigarettes only (alcohol disorder aOR = 9.6, 95% CI = 8.8-10.6; marijuana disorder aOR = 20.4, 95% CI = 18.1-23.0; other drug disorder aOR = 9.4, 95% CI = 7.8-11.4), then users of alternative tobacco products only (alcohol disorder aOR = 8.1, 95% CI = 6.7-9.6; marijuana disorder aOR = 9.2, 95% CI = 7.5-11.4; other drug disorder aOR = 3.2, 95% CI = 2.4-4.3). CONCLUSIONS Tobacco use in adolescence is associated with higher rates of substance use disorders across all tobacco users, especially among those who use cigarettes plus other tobacco products.
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Affiliation(s)
| | - Melissa J. Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Edward L. Spitznagel
- Department of Mathematics, Washington University in St. Louis, St. Louis, MO 63130
| | - Richard A. Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Laura Jean Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
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The association between senior student tobacco use rate at school and alternative tobacco product use among junior students in Canadian secondary schools. Tob Induc Dis 2014; 12:8. [PMID: 24808817 PMCID: PMC4012246 DOI: 10.1186/1617-9625-12-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/25/2014] [Indexed: 11/23/2022] Open
Abstract
Background The use of alternative tobacco products (ATPs) has grown in popularity among Canadian youth. This study examined the association between a school-level characteristic (the senior student tobacco use rate) and the current use of manufactured cigarettes, little cigars or cigarillos, cigars, roll-your-own cigarettes, smokeless tobacco (SLT), and a hookah among junior students. Methods This study used nationally representative Canadian data from 29,495 students in grades 9 to 12 as part of the 2010/2011 Youth Smoking Survey. For each ATP, we described rates of senior and junior tobacco use, calculated the variance attributed to school-level factors, and examined the association between the senior student (grades 11 and 12) tobacco use rate and the current use of each ATP among junior students (grades 9 and 10) while accounting for relevant student-level characteristics. SAS 9.3 was used for all analyses. Results Over half of schools sampled had senior students that reported using each ATP. School-level differences accounted for between 14.1% and 29.7% of the variability in ATP current use among junior students. Each one percent increase in the number of senior students at a school that currently use manufactured cigarettes, SLT, or a hookah was significantly independently associated with an increased likelihood that a junior student at that school currently used manufactured cigarettes (OR 1.04, 95% CI 1.01 to 1.06), SLT (OR 1.14, 95% CI 1.06 to 1.24), or a hookah (OR 1.09, 95% CI 1.03 to 1.14). Conclusions Characteristics of the school environment a junior student attends appear to play an important role in ATP use, and tobacco control programs and policies should be designed to ensure that they include strategies to curb the use of all tobacco products. Additional evidence is needed for the impact of comprehensive school-based tobacco control approaches.
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8
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Wolfson M, Pockey JR, Reboussin BA, Sutfin EL, Egan KL, Wagoner KG, Spangler JG. First-year college students' interest in trying dissolvable tobacco products. Drug Alcohol Depend 2014; 134:309-313. [PMID: 24309296 PMCID: PMC4064364 DOI: 10.1016/j.drugalcdep.2013.10.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 10/23/2013] [Accepted: 10/24/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dissolvable tobacco products (DTPs) have been introduced into test markets in the U.S. We sought to gauge the level of interest in trying these products and correlates of interest among potential consumers. METHODS A web-based survey of freshman at 11 universities in North Carolina and Virginia was conducted in fall 2010. Multivariable logistic regression analyses were used to identify correlates of students' likelihood to try DTPs if offered a free sample. RESULTS Weighted prevalence of likelihood to try DTPs was 3.7%. Significant correlates of likelihood to try included male gender, current cigarette smoking, current snus use, sensation seeking, lifetime illicit drug use, and perceived health risk of using DTPs. Among current smokers, current snus use, current use of chewing tobacco, and considering quitting smoking were associated with likelihood to try DTPs. CONCLUSIONS While overall interest in trying these products was low, current users of cigarettes and snus were much more likely than others in trying a free sample. Some current smokers may consider DTPs to be an aid to smoking cessation, although the population-level impact of introducing these products is unknown.
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Affiliation(s)
- Mark Wolfson
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.
| | | | - Beth A. Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Erin L. Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Kathleen L. Egan
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Kimberly G. Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - John G. Spangler
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
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Peloquin MPJ, Hecimovic K, Sardinha J, Stewart SH, Barrett SP. The effect of snus on alcohol-related cigarette administration in dependent and non-dependent smokers. Pharmacol Biochem Behav 2013; 114-115:97-102. [PMID: 24012648 DOI: 10.1016/j.pbb.2013.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 08/19/2013] [Accepted: 08/26/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Alcohol has been found to increase tobacco smoking in both dependent daily smokers (DDS) and nondependent nondaily smokers (NNS), yet little attention has been directed toward examining how different treatments/products modify drinking-related smoking behavior. METHODS This study examined the acute effects of snus (4mg of nicotine) on alcohol-related smoking responses in 18 DDS and 17 NNS. During each double-blind session, participants were randomly assigned to receive one of the following combinations: alcohol and snus, alcohol and placebo snus, placebo alcohol and snus, or placebo alcohol and placebo snus. Participants consumed their assigned beverage before absorbing their session's product, and after 30min participants could self-administer puffs of their preferred brand of cigarette over a 60-minute period using a progressive ratio task. RESULTS Alcohol significantly increased tobacco craving (p<.001) and tended to decrease latency to start smoking (p=.021) but only among NNS. In contrast, snus tended to decrease the number of puffs earned and how hard DDS worked for puffs in both beverage conditions (ps≤.019) but it did not alter the smoking behavior of NNS. Craving was not significantly impacted by snus in either type of smoker. DISCUSSION These findings raise the possibility that different processes mediate alcohol and cigarette co-use in NNS and DDS and suggest that snus may be effective in reducing alcohol-related cigarette use in DDS specifically.
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Affiliation(s)
- Marcel P J Peloquin
- Dalhousie University, Department of Psychology and Neuroscience, Life Science Centre, 1355 Oxford street, PO Box 15000, Halifax, Nova Scotia B3H 4R2, Canada.
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Øverland S, Skogen JC, Lissner L, Bjerkeset O, Tjora T, Stewart R. Snus use and cardiovascular risk factors in the general population: the HUNT3 study. Addiction 2013; 108:2019-28. [PMID: 23909909 DOI: 10.1111/add.12313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 11/27/2012] [Accepted: 07/22/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Snus, a form of smokeless tobacco, is increasingly popular in its traditional Nordic markets, and was recently launched commercially in the United States. We examined the cross-sectional associations between snus use and cardiovascular risk factors, and compared them with the corresponding associations of smoking. DESIGN Cross-sectional study. SETTING The HUNT3 general population survey, Nord-Trøndelag, Norway (2006-08). PARTICIPANTS A general population sample of n = 25 163. MEASUREMENTS Measured triglyceride,- glucose- and high-density lipoprotein (HDL)-cholesterol levels, blood pressure and waist circumference, registry information on gender, age and education level, self-reported snus use, smoking, physical exercise and alcohol use. FINDINGS In age- and gender-adjusted linear regression analyses, extensive snus use was associated with larger waist circumference (b = 1.65, 95% CI = 0.86, 2.43) and higher systolic blood pressure (b = 2.58, 95% CI = 1.48, 3.68), but with higher rather than lower levels of HDL-cholesterol (b = 1.66, 95% CI = 0.79, 2.53). These three differences remained significant after additional adjustment for smoking, education level, physical exercise and alcohol use. Smokers had higher triglyceride and lower HDL-cholesterol than snus users, but lower systolic blood pressure. CONCLUSIONS After adjusting statistically for major confounding variables, Norwegians who use snus extensively have a mixed profile in terms of cardiovascular risk: slightly higher waist circumference and systolic blood pressure but also higher high-density lipoprotein-cholesterol.
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Affiliation(s)
- Simon Øverland
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway; Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Division of Mental Health, National Institute of Public Health, Bergen, Norway
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11
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Larsen E, Rise J, Lund KE. Risk and protective factors of adolescent exclusive snus users compared to non-users of tobacco, exclusive smokers and dual users of snus and cigarettes. Addict Behav 2013; 38:2288-94. [PMID: 23583834 DOI: 10.1016/j.addbeh.2013.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 01/11/2013] [Accepted: 02/19/2013] [Indexed: 11/29/2022]
Abstract
The use of snus is increasing in Norway. In this study we examined differences between adolescents who were exclusive snus users, and adolescent non-users, smokers and dual users of snus and cigarettes on a number of psychosocial factors, categorized as risk variables and protective variables associated with involvement in health compromising behavior. We applied separate logistic regression models, where exclusive snus users (n=740) were compared with non-users (n=904), smokers (n=219), and dual users (n=367). Compared to non-users, the group of exclusive snus users was associated with variables traditionally predicting health risk behavior, such as smoking friends (OR=1.74, SD 1.27-2.38) and truancy (OR=2.12, SD 1.65-2.78). Compared to smokers, exclusive snus users were related to variables traditionally associated with protection against involvement in health risk behavior, e.g. higher academic orientation (OR=1.66, SD 1.12-2.45). Associations with protective factors were also observed when exclusive snus users were compared with dual users. While the group of exclusive snus users was associated with a pattern of psychosocial risk compared to non-users, they showed a more conventional pattern when compared to smokers and dual users. The group of exclusive snus users may be described on a continuum varying from psychosocial risk factors to protective factors of risk involvement depending on the group of comparison.
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Affiliation(s)
- E Larsen
- Norwegian Institute for Alcohol and Drug Research, Postboks 565 Sentrum, 0105 Oslo, Norway.
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