[Use of tobacco among Norwegian pupils in secondary school 1975-2005].
ABSTRACT The proportion of daily smokers in the adult Norwegian population is gradually decreasing. We have examined changes in smoking among secondary school students (1975 - 2005) and changes in snus use (smokeless tobacco) from 1985 through 2005.
The data stem from a series of nationwide surveys carried out by the Norwegian Directorate of Health every fifth year since 1975. The present analyses are based on samples of students born on the 6 th day of any month (n = 32669) in the period 1975 - 2005.
The proportion of daily smokers among 15-year-olds was highest in 1975 (22.6 % among males and 28.4 % among females) and lowest in 2005 (8.5 % among males and 9.5 % among females). There were periods with no decrease during the 1980s and 1990s, and even an increase in smoking. From 2000 to 2005, the proportion of smokers decreased markedly irrespective of how smoking is defined - in all three grades - and for both sexes. The proportion of 15-year-old boys who used snus daily dropped markedly from 1985 to 1990, and increased steadily thereafter (7.9 % in 2005).
The marked decrease in smoking among secondary school students from 2000 to 2005 may result in that fewer of these students will ever start smoking.
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ABSTRACT: Reviews show that using snus (Swedish-type moist snuff) is much safer than smoking, with no increased risk from snus of cancer or circulatory disease yet demonstrated, but have not investigated possible health effects from dual use of cigarettes and snus. This review considers studies where health risks can be compared in dual users, those who only use snus or only smoke, and those who use neither product. The interaction RR, the ratio of RRs associated with snus use in smokers and in non-smokers, was used to test for special effects of dual use. Of 51 interaction RRs presented, only one (for gestational hypertension in a study based on the Swedish Medical Register) was significantly (p<0.05) above 1.0, and RRs below 1.0 were commoner, perhaps as cigarette consumption is lower in dual users than those who only smoke. Dual users more often initiate tobacco use with cigarettes than snus. Dual use is much commoner in adolescents than adults, possibly because many tobacco users try both products, eventually settling on one. Epidemiological evidence from various sources, though suffering from weaknesses, consistently suggests concomitant snus use increases smoking quit rates, and aligns with evidence from RCTs using snus to aid smoking cessation.Regulatory Toxicology and Pharmacology 10/2013; 69(1). DOI:10.1016/j.yrtph.2013.10.007 · 2.14 Impact Factor
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ABSTRACT: BACKGROUND: The use of moist snuff (snus) in young Norwegians is increasing, while smoking rates are declining. It is not clear whether snus facilitates smoking. OBJECTIVE: To assess whether 16-year-old men who were never-smokers, but snus users in 2001, had an increased risk of smoking 3 years later. METHODS: In a prospective school-based cohort study, 1440 men, who responded to questionnaires in 2001 and 2004, were included in the analyses. The participation rate was 89% in 2001 and 50% in 2004. Multinomial logistic regression models were used to assess the OR of snus users, smokers and dual users of cigarettes and snus, compared with non-tobacco users at baseline, to be smokers at follow-up. RESULTS: Snus use at baseline was associated with increased odds of dual use at follow-up when the outcome was (1) current dual use versus no tobacco (OR 3.49, 95% CI 1.8 to 6.8) and when the outcome was (2) current dual use versus no smoking but including snus-only use (OR 1.88, 95% CI 1.1 to 3.3). Baseline snus users who were dual users at follow-up seemed to prefer using snus daily and cigarettes occasionally. Use of snus only at baseline was not associated with increased odds of smoking only at follow-up, after adjusting for known risk factors. CONCLUSIONS: Young men who only used snus at baseline had an increased risk of being dual users at follow-up. Snus use may therefore facilitate smoking.Tobacco control 05/2012; 22(6). DOI:10.1136/tobaccocontrol-2011-050158 · 5.15 Impact Factor
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ABSTRACT: Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18months to age 18–19years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (b = 0.17, p,0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: b = 0.85,p,0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: b = 0.55,p,0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.PLoS ONE 05/2013; 8(5):e63252. DOI:10.1371/journal.pone.0063252 · 3.53 Impact Factor