Unhealthy eating and weight dissatisfaction in adolescents who never, occasionally, or regularly use smokeless tobacco (Swedish snus)

Abstract

Objective: Although cigarette smoking has been linked to weight-related concerns and unhealthy weight control practices, little is known about weight dissatisfaction and eating among adolescents who use smokeless tobacco (SLT) products. The use of Swedish moist snuff (snus) has increased dramatically over recent years, surpassing cigarette smoking among young people in several countries. This study investigated differences in unhealthy eating behaviors and weight dissatisfaction in male and female adolescents who never, occasionally, or regularly use snus.Method: Adolescents aged 16-19 years enrolled in high school (11th, 12th, and 13th grades) completed a cross-sectional, online survey of adolescent health and wellbeing. Meal skipping and snus use frequency were assessed in the total sample (N = 23,622), and items assessing weight dissatisfaction (n = 4,195) and eatingrelated pathology (n = 3,563) were administered to subsamples. Analyses were adjusted for cigarette smoking, parental education, and socioeconomic status.Results: Adolescents who used snus, especially on a daily basis, reported less regular breakfast, lunch, and dinner consumption. Females who used snus on an occasional basis reported significantly more disturbed eating pathology. Snus use was associated with weight dissatisfaction in males and females, manifesting differentially according to gender and snus use frequency.

Physical Fitness, Dietary Habits and Substance Misuse: A Cross-Sectional Analysis of the Associations in 7,600 Swedish Adolescents

“…In support, studies confirmed that the desire to be thin and control weight was positively associated with increased cigarette smoking in adolescents, particularly among girls (Kendzor et al, 2007). Moreover, a study conducted on Swedish adolescents, aged 16-19 years, reported the association between increased snus use and unhealthy eating behaviours (Reas et al, 2019). Specifically, in both genders, meal skipping was more frequent among adolescents that use snus, while girls using snus had two to three times higher odds of skipping breakfast, lunch and dinner.…”

“…Specifically, in both genders, meal skipping was more frequent among adolescents that use snus, while girls using snus had two to three times higher odds of skipping breakfast, lunch and dinner. Importantly, girls who used snus perceived themselves as overweight; thus, they probably used snus to decrease their weight and form better body shape (Reas et al, 2019). Even the studies in aesthetic sports confirmed such findings, where authors repeatedly reported smoking in female professionals who strive to maintain their body weight at a low level (i.e.…”

Dietary habits among snus users: a population-based cross-sectional study

“…In a previous Swedish study (9,954 participants, including 839 exclusive snus users), it was reported that snus users were less likely to be daily consumers of fruit and berries than non-tobacco users (21). In that study, as well as in a previous Norwegian study (23,622 participants, including 4,918 occasional or daily snus users) (20), snus users also had less regular eating habits than non-tobacco users.…”

“…Interestingly enough, the dietary habits of snus users have seldom been studied. One Norwegian study found that snus users were less likely to have regular eating habits than their non-using peers ( 20 ), and a Swedish study found that snus users were less likely to have regular breakfast habits and to be daily consumers of fruit and berries compared with non-tobacco users ( 21 ). In contrast, it is well-established that cigarette smokers have unhealthier diets than non-tobacco users with respect to both macronutrients (exemplified by, among others, higher intakes of total and saturated fat and lower intakes of polyunsaturated fat and fiber) ( 22 ) and overall diet quality (exemplified by a higher dietary energy density [energy per gram of food]) ( 23 ).…”