Expectancies and intentions to use snus among Norwegian first-year students

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

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 well-being. Meal skipping and snus use frequency were assessed in the total sample (N = 23,622), and items assessing weight dissatisfaction (n = 4,195) and eating-related 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.

DISCUSSION

Unhealthy eating behaviors and weight dissatisfaction were significantly elevated among snus users aged 16-19 years. An increased awareness that occasional snus use may signal disturbed eating pathology among adolescent females is important for detection and prevention efforts. Parents, schools, and health professionals should be vigilant for possible snus use among weight-dissatisfied adolescents.

Application of the Smokeless Tobacco Expectancies Questionnaire to Snus

OBJECTIVE

Measures of consumer perceptions of emerging tobacco products are needed for understanding the potential for product adoption and use. The purpose of this research was to evaluate the applicability of the Smokeless Tobacco Expectancies Questionnaire to snus, and examine its association with interest in using snus.

METHODS

We recruited 116 adolescents (14-17 years of age), 463 young adults (18-34 years of age), and 596 older adults (35-65 years of age) from a Web-based opt-in panel. Participants completed a 10-item Snus Expectancies Questionnaire and questions about their interest in trying snus in the next month.

RESULTS

Confirmatory factor analysis supported a latent factor structure representing Positive Reinforcement (PR) and Negative Health Consequences (NHC) within each age group. The scales differentiate smokers and smokeless tobacco users and nonusers. Each scale was associated with interest in purchasing snus for younger (PR: OR 1.90; NHC: OR 0.66) and older (PR: OR 1.36; NHC: OR 0.69) adults controlling for tobacco use status.

CONCLUSIONS

The modified Smokeless Tobacco Expectancies Questionnaire is a valid measure of snus-related outcome expectancies, which are in turn, associated with self-reported tobacco use, and may help to identify groups who are susceptible to snus initiation and use.