Intergenerational social mobility, smoking and smokeless tobacco (snus) use among adolescents during 2008–2017

Ruokolainen, Otto; Ollila, Hanna; Lahti, Janne; Rahkonen, Ossi

doi:10.1016/j.addbeh.2019.06.011

Cited by 15 publications

(14 citation statements)

References 33 publications

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“…Finland aims to be tobacco and nicotine free by 2030 [28]. Our results, alongside findings from the earlier investigations showing widening educational differences in tobacco use [1,29], suggest that supporting the less educated is pivotal if this objective is to be reached. Enhanced smoking cessation support should also be targeted at highly addicted smokers, as well as at those with at least moderate symptoms of depression.…”

Section: Discussionsupporting

confidence: 66%

Association between educational level and smoking cessation in an 11-year follow-up study of a national health survey

Ruokolainen

Härkänen

Lahti

et al. 2021

Scand J Public Health

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Aims: There is a lack of longitudinal, population-based studies on the association between education and smoking cessation. A more thorough examination of this association is needed to address inequalities in smoking. Methods: The longitudinal Health 2000 Survey and Health 2011 Survey, representing the Finnish population aged ⩾30 years, were analysed. Of the 1352 baseline daily smokers, 945 (70%) provided a smoking status at the follow-up. The analytic sample size was 884 (excluding the follow-up occasional smokers). Self-reported questionnaire data and measurements (e.g. plasma cotinine) from the baseline were utilised. The outcome variable was smoking cessation at the follow-up, and the main explanatory variable was education. Logistic regression was the main method for statistical analyses. All of the analyses accounted for the sampling design. Results: At the follow-up, 28% of the baseline daily smokers had quit smoking. An adjusted regression model showed that highly educated respondents had a higher likelihood of quitting smoking compared with those with basic education. Controlling for demographic and health-related variables had a modest effect on this association. Higher scores for plasma cotinine, symptoms of depression and heavy alcohol use were associated with a lower likelihood of quitting smoking. The association between education and smoking cessation was weaker for women than it was for men. Conclusions: High education is associated with smoking cessation among the general adult population, especially among men. A higher plasma cotinine level is strongly associated with continued smoking among both sexes. Background variables only modestly affected the association between education and smoking cessation.

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Section: Discussionsupporting

confidence: 66%

Association between educational level and smoking cessation in an 11-year follow-up study of a national health survey

Ruokolainen

Härkänen

Lahti

et al. 2021

Scand J Public Health

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“…In fact, there has internationally been an increasing trend in youth use of e-cigarettes, snus, and waterpipe in recent years (18)(19)(20)(21). In e.g., USA and Norway, the use of some ATPs has even exceeded the use of conventional cigarettes (22)(23)(24). However, the research on socioeconomic differences in the use of ATPs is somewhat inconsistent and limited, with some research indicating a social gradient in the uptake of ATPs among students from different socioeconomic groups (18,25), while other studies found no socioeconomic differences in the use of ATPs (26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Differences in Cigarette Smoking and Alternative Tobacco Product Use Among Adolescents in a School-Based Smoking Preventive Intervention: Findings From the Second Year of the X:IT II Study

Kjeld

Lund

Andersen

et al. 2022

Front. Public Health

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BackgroundHealth interventions may differently impact adolescents from diverse backgrounds. This study examined whether a smoking preventive intervention was equally effective in preventing cigarette smoking and use of alternative tobacco products (ATPs, i.e., snus, e-cigarettes, and waterpipe) among students from different socioeconomic backgrounds, i.e., occupational social classes (OSC).MethodsData was from the school-based intervention X:IT II targeting 13- to 15-year-olds Danes. The intervention focused on three main components: smoke-free school time, smoke-free curriculum, and parental involvement. In total, 46 schools were included at baseline (N = 2,307, response rate = 86.3%). Using a difference-in-differences approach, changes in current smoking and ever use of ATPs were estimated among students in high versus low OSC at second follow-up. Analyses were based on available cases (N = 826) and multiple imputations of missing data at the second follow-up (N = 1,965).ResultsAt baseline (age 13), 1.0% of students from high OSC and 4.8% from low OSC currently smoked cigarettes, while this was the case among 24.5 and 25.6%, respectively, at the second follow-up (age 15). Estimates indicated that social inequalities in current smoking diminished over time (p < 0.001). Regarding ATPs, 10.0% of high OSC students and 13.9% of low OSC students had ever used ATPs at baseline, while at second follow-up, 46.8 and 60.8%, respectively, had ever used ATPs. Estimates indicated that social inequalities in ever use of ATPs widened over time (p < 0.001).ConclusionsThe X:IT II intervention seemed to diminish socioeconomic disparities in smoking over the study period. Meanwhile, social inequalities in ever use of ATPs increased. Therefore, besides focusing on narrowing the social disparities in cigarette smoking, future efforts may, to a larger extent, focus on adolescents' use of ATPs.

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“…Snus is a smokeless tobacco product traditionally used in Scandinavia, most notably in Sweden and Norway, 1 , 2 but also increasingly common in Finland, especially among young adults. 3 Sales of snus is also steadily increasing in the United States, 4 and Swedish Match, the largest snus manufacturer in Sweden, has successfully obtained approval from the U.S. Food and Drug Administration (FDA) to market eight snus products as Modified Risk Tobacco Products on the U.S. market. 4 , 5 Swedish Match has also sought access to the European market, where sale of snus is currently banned, 6 and shown interests in Asian and African markets.…”

Section: Introductionmentioning

confidence: 99%

Nicotine Content in Swedish-Type Snus Sold in Norway From 2005 to 2020

Vedøy

Lund

2022

Nicotine &Amp; Tobacco Research

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Introduction Use of snus (moist smokeless tobacco) is widespread in Scandinavia and increasingly popular in the U.S. Snus products vary in terms of product design, portion size and nicotine content. The aim of this study was to examine variations in the nicotine content in snus sold on the Norwegian market from 2005 to 2020. Methods We calculated the nicotine content in dry snus in milligram per gram (mg/g) and milligram per serving (mg/s), weighted by the products’ market share from data on nicotine content, water content and portion size (both for portion and loose snus) for the ten most sold snus products from each of the three largest manufacturers in 2005, 2010, 2015 and 2020. Results In all snus products combined, the nicotine content per gram snus (mg/g) increased from 16.3 to 24.1, while nicotine per serving (mg/s) was stable around 13.0. In portion snus, the nicotine content increased for both mg/g and mg/s, most notably from 2005 to 2010. In loose snus, mg/g decreased marginally, while mg/s was stable throughout the period. Conclusions In a period with increasing snus use, the nicotine content in snus increased per gram snus, but not per serving. The stability in nicotine per serving is likely due to a decreasing market share of loose snus which accounted for 54 percent of the snus products in 2005 and 5 percent in 2020, and which traditionally has a high content of nicotine per serving. Implications Use of snus is popular in Scandinavia, most notably in Sweden and Norway, but also increasingly common in Finland, especially among young adults. There are no prior market based studies of variations in the nicotine content in Swedish snus over time. We found that the average amount of nicotine per gram snus sold on the Norwegian market increased in the period 2005 to 2020, most notably from 2005 to 2010, while the amount of nicotine per serving was stable in the same period, primarily due to a decreasing share of loose snus.

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Intergenerational social mobility, smoking and smokeless tobacco (snus) use among adolescents during 2008–2017

Cited by 15 publications

References 33 publications

Association between educational level and smoking cessation in an 11-year follow-up study of a national health survey

Association between educational level and smoking cessation in an 11-year follow-up study of a national health survey

Socioeconomic Differences in Cigarette Smoking and Alternative Tobacco Product Use Among Adolescents in a School-Based Smoking Preventive Intervention: Findings From the Second Year of the X:IT II Study

Nicotine Content in Swedish-Type Snus Sold in Norway From 2005 to 2020

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