Tobacco use among Norwegian adolescents: from cigarettes to snus

Abstract

Aims To: (i) investigate the development of smoking and snus use among Norwegian adolescents, and (ii) describe the users in each group. Design Two population-based surveys with identical procedures in 2002 (response rate 91.0%) and 2010 (response rate 84.3%). Setting Norway. Participants A total of 6217 respondents, aged 16–17 years. Measurements Data were collected on smoking and snus use, socio-demographic factors, school adjustment, social network, sport activities, alcohol and cannabis use and depression symptoms. Findings Prevalence of daily smoking fell from 23.6% in 2002 to 6.8% in 2010 (P < 0.001), while the prevalence of daily snus use increased from 4.3 to 11.9% (P < 0.001). Dual daily use of cigarettes and snus remained at 1%. The relative proportion of non-daily smokers using snus increased steeply. Both snus users and smokers reported more adverse socioeconomic backgrounds, less favourable school adjustment and higher levels of alcohol intoxication and cannabis use than non-users of tobacco. However, snus users were better adjusted to school and used cannabis less often than smokers. Conclusions Adolescent smoking prevalence has fallen dramatically in Norway, accompanied by a smaller increase in snus use. Young snus users in Norway have many of the same risk factors as smokers, but to a lesser degree.