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  • Title: Patterns of snus and cigarette use: a study of Norwegian men followed from age 16 to 19.
    Author: Grøtvedt L, Forsén L, Stavem K, Graff-Iversen S.
    Journal: Tob Control; 2013 Nov; 22(6):382-8. PubMed ID: 22634571.
    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.
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