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López-Cervantes JP, Schlünssen V, Senaratna C, Accordini S, Callejas FJ, Franklin KA, Holm M, Jogi NO, Malinovschi A, Oudin A, Sigsgaard T, Thorarinsdottir EH, Janson C, Bertelsen RJ, Svanes C. Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study. BMJ Open Respir Res 2024; 11:e002401. [PMID: 39038916 PMCID: PMC11268032 DOI: 10.1136/bmjresp-2024-002401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/28/2024] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES To investigate the association of early snus use initiation (≤15 years of age) with asthma and asthma symptoms. DESIGN Cross-sectional analysis of a population-based cohort. SETTING Study centres in Norway, Sweden, Iceland, Denmark and Estonia, from 2016 to 2019. PARTICIPANTS 9002 male and female participants above 15 years of age of the Respiratory Health in Northern Europe, Spain and Australia study. MAIN OUTCOME MEASURES Current asthma and asthma symptoms. RESULTS The median age of study participants was 28 years (range 15-53) and 58% were women. 20% had used snus, 29% men and 14% women. Overall, 26% of males and 14% of females using snus started ≤15 years of age. Early snus use initiation was associated with having three or more asthma symptoms (OR 2.70; 95% CI 1.46 to 5.00) and a higher asthma symptom score (β-coefficient (β) 0.35; 95% CI 0.07 to 0.63) in women. These associations were weak in men (OR 1.23; 95% CI 0.78 to 1.94; β 0.16; 95% CI -0.06 to 0.38, respectively). There was evidence for an association of early snus initiation with current asthma (OR 1.72; 95% CI 0.88 to 3.37 in women; OR 1.31; 95% CI 0.84 to 2.06 in men). A sensitivity analysis among participants without smoking history showed stronger estimates for all three outcomes, in both men and women, statistically significant for three or more asthma symptoms in women (OR 3.28; 95% CI 1.18 to 9.10). Finally, no consistent associations with asthma outcomes were found for starting snus after age 15 years. CONCLUSIONS Snus initiation in puberty was associated with higher likelihood of asthma and asthma symptoms, with the highest estimates in females and those without smoking history. These results raise concerns about the health adversities of early snus initiation and emphasise the need for public health initiatives to protect young people from this tobacco product.
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Affiliation(s)
- Juan Pablo López-Cervantes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Chamara Senaratna
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne VCCC, Victoria, Melbourne, Australia
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umea, Sweden
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Nils Oskar Jogi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Umeå University, Umea, Sweden
| | - Torben Sigsgaard
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Elin Helga Thorarinsdottir
- Primary Health Care of the Capital Area, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | | | - Cecilie Svanes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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Medianfar CE, Jemec GBE. Global differences in tobacco use: who is using what? Br J Dermatol 2023; 190:117-118. [PMID: 37768135 DOI: 10.1093/bjd/ljad379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
Hidradenitis suppurativa has been associated with tobacco use, but often only smoking status is recorded. In order to further our understanding on this association, local and cultural differences in tobacco use must be considered in future research.
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Affiliation(s)
| | - Gregor B E Jemec
- Department of Dermato-Venerology, Zealand University Hospital, Roskilde
- Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
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Ibarra-Sanchez AS, Abelsen B, Chen G, Wisløff T. Educational patterns of health behaviors and body mass index: A longitudinal multiple correspondence analysis of a middle-aged general population, 2007-2016. PLoS One 2023; 18:e0295302. [PMID: 38039296 PMCID: PMC10691680 DOI: 10.1371/journal.pone.0295302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/10/2023] [Indexed: 12/03/2023] Open
Abstract
Social differences in body mass index and health behaviors are a major public health challenge. The uneven distribution of unhealthy body mass index and of unhealthy behaviors such as smoking, physical inactivity, and harmful alcohol consumption has been shown to mediate social inequalities in chronic diseases. While differential exposures to these health variables have been investigated, the extent to which they vary over the lifetime in the same population and their relationship with level of education is not well understood. This study examines patterns of body mass index and multiple health behaviors (smoking, physical activity and alcohol consumption), and investigates their association with education level among adults living in Northern Norway. It presents findings from a longitudinal multiple correspondence analysis of the Tromsø Study. Longitudinal data from 8,906 adults aged 32-87 in 2007-2008, with repeated measurements in 2015-2016 were retrieved from the survey's sixth and seventh waves. The findings suggest that most in the study population remained in the same categories of body mass index and the three health behaviors at the follow-up, with a clear educational gradient in healthy patterns. That is, both healthy changes and maintained healthy categories were associated with the highest education levels. Estimating differential exposures to mediators of health inequalities could benefit policy priority setting for tackling inequalities in health.
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Affiliation(s)
| | - Birgit Abelsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Torbjørn Wisløff
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
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Harris SM, Jørgensen M, Lowthian E, Kristensen SM. Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study. BMC Public Health 2023; 23:2022. [PMID: 37848880 PMCID: PMC10580607 DOI: 10.1186/s12889-023-16952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Socioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called "alcohol harm paradox" (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more alcohol-related harm). Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible "smoking harm paradox" (SHP). We aim to fill this gap. METHODS We conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report. RESULTS Overall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income. CONCLUSIONS While our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. This effect was not found for parental income, highlighting the potential influence of parental education over income as a determinant of subjective health outcomes in relation to smoking.
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Affiliation(s)
- Samantha Marie Harris
- Department of Health Promotion and Development, University of Bergen, Alrek helseklynge, Årstadveien 17, Bergen, 5009, Norway
| | - Magnus Jørgensen
- Department of Health Promotion and Development, University of Bergen, Alrek helseklynge, Årstadveien 17, Bergen, 5009, Norway.
| | - Emily Lowthian
- Department of Education and Childhood Studies, Swansea University, Singleton Campus, Swansea, Wales, SA2 8PP, UK
| | - Sara Madeleine Kristensen
- Department of Health Promotion and Development, University of Bergen, Alrek helseklynge, Årstadveien 17, Bergen, 5009, Norway
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Danielsson M, Lammi A, Siitonen S, Ollgren J, Pylkkänen L, Vasankari T. Factors predicting willingness to quit snus and cigarette use among young males. Sci Rep 2023; 13:15126. [PMID: 37704673 PMCID: PMC10499985 DOI: 10.1038/s41598-023-42233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
The health hazards of smoking are well recognised and recently knowledge about the harmful effects of nicotine and snus is accumulating. We investigated the factors increasing the willingness of young Finnish males to quit snus and cigarette smoking. We conducted a questionnaire study conducted in 3 out of 16 Finnish Defence Forces units which included 6508 male conscripts, of whom 4706 responded (response rate 72%, mean age 19.4 years). Factors related to the willingness to quit use were analysed by ordinal regression models. Backward selection following the Akaike information criterion (AIC) was used for the model. The prevalence figures of daily snus use and smoking were 17% and 25%, respectively. 16% of the daily snus users were also daily smokers and 29% were occasional smokers. Multivariate analysis showed that the willingness to quit snus use was associated with the perception of health hazards (OR 3.09, 95% CI 1.94-4.93) and with ≥ 2 quit attempts (OR 3.63, 95% CI 2.44-5.40). The willingness to quit smoking was associated with ≥ 2 quit attempts (OR 3.22, 95% CI 2.32-4.49), and with advice to quit smoking (OR 1.65, 95% CI 1.17-2.32). We created a brief two-question assessment model for snus dependence. With this model, nicotine dependence of daily snus users was congruent with that of nicotine dependence of smokers. A direct comparison with serum cotinine levels is necessary before our assessment model can be used as a proxy for dependence. Regular snus use predisposes to nicotine addiction and accumulated health hazards. Our findings underscore the importance of health promotion efforts in early adolescence and of active support for quitting snus use. Easily applicable tools to estimate nicotine addiction are needed for everyday clinical use.
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Affiliation(s)
- Maria Danielsson
- The Finnish Defence Forces, Kasarminkatu 17, 00130, Helsinki, Finland.
- Doctoral Programme in Population Health, University of Helsinki, P.O. BOX 3, 00014, Helsinki, Finland.
| | - Anelma Lammi
- Finnish Lung Health Association (FILHA), Filha Ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland
| | - Simo Siitonen
- The Finnish Defence Forces, Kasarminkatu 17, 00130, Helsinki, Finland
| | - Jukka Ollgren
- National Institute for Health and Welfare, P.O. BOX 30, 00271, Helsinki, Finland
| | - Liisa Pylkkänen
- Finnish Medicines Agency Fimea, Helsinki, Finland
- Division of Medicine, Department of Oncology, Turku University Hospital and University of Turku, P.O. BOX 52, 20521, Turku, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association (FILHA), Filha Ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, P.O. BOX 52, 20521, Turku, Finland
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Glastad SH, Aminoff SR, Hagen R, Høegh MC, Büchmann CB, Barrett EA, Melle I, Etain B, Lagerberg TV. Nicotine use and non-pathological alcohol use and their relationship to affective symptoms and sleep disturbances in bipolar disorder. J Affect Disord 2023; 327:236-243. [PMID: 36746243 DOI: 10.1016/j.jad.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND The use of alcohol and nicotine can negatively impact the course of bipolar disorder (BD), but there is limited knowledge about how symptoms and sleep disturbances are related to concurrent nicotine use and non-pathological use of alcohol. METHODS We investigated how nicotine use and non-pathological use of alcohol relates to affective symptoms and sleep disturbances in 453 participants with BD without substance use disorders. Manic symptoms were assessed with the Young Mania Rating Scale, and depressive symptoms with The Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C). Sleep-related questions from IDS-C were used to create proxy variables for sleep disturbances, including Insomnia and Hypersomnia. Multinomial regression analysis was conducted to investigate the associations between nicotine use and sleep disturbances, controlling for possible confounders such as current use of illicit drugs and psychopharmacological treatment. RESULTS Depressive and manic symptoms were not associated with the concurrent level of alcohol or nicotine use. Individuals with medium and high levels of daily nicotine use had higher risk of insomnia than those without. Non-pathological alcohol use was not associated with sleep disturbances. LIMITATIONS Sleep disturbances were based on items from the IDS-C questionnaire. CONCLUSION We found an elevated risk for insomnia in individuals with BD and medium or high levels of daily nicotine use. We found no association between the level of affective symptoms and the level of use of alcohol or nicotine. The direction of the relationship between nicotine use and insomnia needs clarification, as it is highly relevant for treatment planning.
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Affiliation(s)
- Stine Holmstul Glastad
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
| | - Sofie Ragnhild Aminoff
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Roger Hagen
- Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Research institute, Modum Bad, Vikersund, Norway
| | - Margrethe Collier Høegh
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Camilla Bakkalia Büchmann
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Elizabeth Ann Barrett
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Bruno Etain
- INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France; Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France; Université Paris Cité, Paris, France; Fondation FondaMental, Créteil, France
| | - Trine Vik Lagerberg
- NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
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Raninen J, Gripe I, Zetterqvist M, Ramstedt M. Trends in Tobacco Use among 9th Graders in Sweden, 1991-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5262. [PMID: 37047878 PMCID: PMC10093943 DOI: 10.3390/ijerph20075262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/28/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
Tobacco use was measured with self-reports of lifetime use of cigarettes and snus to examine trends in tobacco use among Swedish 9th graders over the period 1991-2020. Annual school surveys with nationally representative samples of 9th-grade students in Sweden covering the period 1991-2020 with a total sample of 163,617 students. We distinguished between the use of cigarettes only, use of snus only, dual use (use of both cigarettes and snus), and total tobacco use (use of any of these tobacco products). In addition to a graphical description of trends in the various measures of tobacco use, the correlation between these trends was calculated with the Pearson correlation coefficient (Rxy). The prevalence of total tobacco use declined from 72% in 1991 to 36% in 2020. The declining trend in total tobacco use was positively correlated with the trend in dual use (Rxy = 0.98) and the trend in cigarette use only (Rxy = 0.87). The trend in total tobacco use was, on the other hand, negatively correlated with snus use only (Rxy = -0.41), and snus use only was negatively correlated with cigarette use only (Rxy = -0.71). The situation became different after 2017 when total tobacco use increased as a result of an increasing prevalence of snus use. The sharp decline in tobacco use among 9th graders in Sweden over the past three decades is driven by declining cigarette use. The correlations between the various forms of tobacco use suggest that snus use may have contributed to the decline in cigarette use and, by that, overall tobacco use. The situation changed after 2017 when a sharp rise in snus use seems to have increased total tobacco use among adolescents in Sweden. A possible explanation behind this development is the introduction of a new form of snus called "All white snus", which was introduced in Sweden in 2014.
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Affiliation(s)
- Jonas Raninen
- Swedish Council for Information on Alcohol and Other Drugs (CAN), 116 64 Stockholm, Sweden; (J.R.); (I.G.); (M.Z.)
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC 3086, Australia
| | - Isabella Gripe
- Swedish Council for Information on Alcohol and Other Drugs (CAN), 116 64 Stockholm, Sweden; (J.R.); (I.G.); (M.Z.)
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Martina Zetterqvist
- Swedish Council for Information on Alcohol and Other Drugs (CAN), 116 64 Stockholm, Sweden; (J.R.); (I.G.); (M.Z.)
| | - Mats Ramstedt
- Swedish Council for Information on Alcohol and Other Drugs (CAN), 116 64 Stockholm, Sweden; (J.R.); (I.G.); (M.Z.)
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Public Health, Stockholm University, 106 91 Stockholm, Sweden
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Lund L, Bast LS, Rubæk M, Andersen S. Exploring factors associated with smokeless tobacco use among young people: A systematic scoping review. Drug Alcohol Depend 2022; 240:109627. [PMID: 36167002 DOI: 10.1016/j.drugalcdep.2022.109627] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE While smoking is declining among young people, smokeless tobacco use is increasing. Identifying who is using smokeless tobacco and why is essential in preventing smokeless tobacco use. This study aimed to comprehensively explore the factors of young people's use of smokeless tobacco in western countries and identify research gaps. METHODS We conducted a systematic scoping review of studies that examined factors associated with smokeless tobacco use among young people (ages 13-29) from western countries published between January 2011 and September 2021. Searches were conducted in CINAHL, Medline, and Scopus. Studies on adults, total tobacco use (i.e., did not differentiate between tobacco product types), dual and multiple uses of tobacco, and studies on smokeless tobacco cessation programs were excluded. RESULTS A total of 160 studies were included in this scoping review. The studies were primarily undertaken in the US and the Scandinavian countries, and the majority explored smokeless tobacco use without distinguishing between the specific types. Smokeless tobacco users were more likely to be male, non-Hispanic white, engaging in physical activity, and using other substances, including cigarettes and alcohol. The role of friends and family were identified as critical factors that were related to the use of smokeless tobacco. CONCLUSIONS This scoping review suggests that preventative measures against smokeless tobacco use should focus on peer and family members' roles and that these measures may benefit from targeting males. Additional research, including systematic reviews on this area to validate the identified associated factors, would improve the understanding of smokeless tobacco use.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Mette Rubæk
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
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Hjetland GJ, Finserås TR, Sivertsen B, Colman I, Hella RT, Skogen JC. Focus on Self-Presentation on Social Media across Sociodemographic Variables, Lifestyles, and Personalities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711133. [PMID: 36078843 PMCID: PMC9518022 DOI: 10.3390/ijerph191711133] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 05/06/2023]
Abstract
Upward social comparison and aspects of self-presentation on social media such as feedback-seeking and strategic self-presentation may represent risk factors for experiencing negative mental health effects of social media use. The aim of this exploratory study was to assess how adolescents differ in upward social comparison and aspects of self-presentation on social media and whether these differences are linked to sociodemographic variables, lifestyle, or personality. The study was based on cross-sectional data from the "LifeOnSoMe" study performed in Bergen, Norway, including 2023 senior high school pupils (response rate 54%, mean age 17.4, 44% boys). Nine potentially relevant items were assessed using factor analysis, and latent class analysis was used to identify latent classes with distinct patterns of responses across seven retained items. The retained items converged into one factor, called "focus on self-presentation". We identified three groups of adolescents with a low, intermediate, and high focus on self-presentation. Associations between identified latent classes and covariates were assessed using regression analyses. Being a girl, higher extraversion, lower emotional stability, more frequent alcohol consumption, and having tried tobacco were associated with membership in the high-focus group. These results suggest some characteristics that are associated with a higher focus on self-presentation and that could inform targeted interventions.
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Affiliation(s)
- Gunnhild Johnsen Hjetland
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, 0473 Oslo, Norway
- Correspondence:
| | - Turi Reiten Finserås
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
- Department of Research and Innovation, Helse Fonna HF, 5525 Haugesund, Norway
- Department of Mental Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Randi Træland Hella
- Department of Work, Section for Children, Families and Disabled, Social Services and Housing, 5014 Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, 0473 Oslo, Norway
- Alcohol and Drug Research Western Norway, Stavanger University Hospital, 4036 Stavanger, Norway
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Tjora T, Skogen JC, Sivertsen B. Establishing the Association Between Snus Use and Mental Health Problems: A Study of Norwegian College and University Students. Nicotine Tob Res 2022; 25:135-142. [PMID: 36037069 PMCID: PMC9717367 DOI: 10.1093/ntr/ntac208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Smoking and mental health problems are public health concerns worldwide. Studies on smoke-free tobacco products, especially snus are scarce. Snus is considered less harmful than smoking and in the United States allowed to be marketed accordingly, but may still add to the burden of disease. AIMS AND METHODS Data stem from the Norwegian Students' Health and Wellbeing Study (SHoT study) in 2018 (162 512 invited, 50 054 (30.8%) completed). Smoking, snus use, health service and medication usage and mental health problems, including the Hopkins Symptom Checklist-25 (HSCL-25), were assessed using self-report. The aims were to explore the associations between smoking and snus use and mental health problems and treatments. Furthermore, the association between both daily smoking and daily snus use and mental health problems. Associations were tested with χ2-, t-tests, and logistic regression. RESULTS Daily snus users had 38% increased odds (odds ratio [OR]: 1.38, CI: 1.30 to 1.46), and daily smokers had 96% increased odds (OR: 1.96, CI: 1.65 to 2.34) of having a high HSCL-25 score, adjusted for gender, low socioeconomic status (SES), using tobacco, participating in therapy and using antidepressants daily. CONCLUSIONS Both daily smoking and daily snus use were associated with an increased level of mental health problems. The adjusted probability for mental health problems was lower for snus use; however, snus use prevalence was tenfold in our sample. IMPLICATIONS Despite the lack of causal and directional conclusions, these associations may have implications for future legislation on snus. They also highlight the importance of more research, especially as snus is considered less harmful and seemingly replacing smoking in Norway.
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Affiliation(s)
- Tore Tjora
- Corresponding Author: Tore Tjora,PhD, Department of Social Studies, University of Stavanger, Post Box 8600, 4036 STAVANGER, Norway. Telephone: +47 51833618; E-mail:
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway,Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Sharma A, June KM, Norton KJ, Fix B, Bansal-Travers M, Rees VW, J O'Connor R. Intention to purchase alternative tobacco products as a function of smoking status and responses to advertising, packaging, and sensory experiences. Addict Behav 2022; 130:107291. [PMID: 35220153 DOI: 10.1016/j.addbeh.2022.107291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/07/2021] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Tobacco manufacturers design and marketed products with appealing sensory characteristics to drive product uptake and continued use. We assessed smokers' and non-smokers' cognitive, affective, and sensory responses to Camel Snus (CS) and Nicotine gum (NG) to gauge future intentions to use. METHOD In a single laboratory session, 348 participants (including current smokers and nonsmokers in Buffalo, NY and Boston, MA) were exposed to CS and NG products in counterbalanced order. Exposure involved a cumulative set of 3 steps in which participants i) viewed an advertisement; ii) viewed the packaging, and iii) touched and smelled the product, without actual use. Current daily and non-daily smokers were invited to undertake a fourth exposure step by sampling the product. Following product exposure, participants completed perception measures and reported future intentions to use either product at the end of the survey. After each exposure, participants' reported feelings of valence and arousal. RESULTS Smokers reported greater preference to try NG (63.8%) compared with CS (17.4%) or neither (18.8%), whereas majority of nonsmokers preferred neither product (64.3%) (p < 0.01). Of those offered to sample the products, 78.3% daily smokers and 68.4% non-daily smokers opted to sample. When asked about intentions to try, a greater proportion of smokers stated a preference to try NG over CS, as did the small number of nonsmokers who expressed a preference. CONCLUSION Intentions to try CS were low despite different levels of exposure to product, and this low product appeal and interest in use may translate to limited potential of CS to serve as a reduced harm product for smokers.
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Affiliation(s)
- Akshika Sharma
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, United States.
| | - Kristie M June
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, United States.
| | - Kaila J Norton
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, United States; Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, United States.
| | - Brian Fix
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, United States.
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, United States.
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States.
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, United States.
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Danielsson M, Tanner T, Patinen P, Birkhed D, Anttonen V, Lammi A, Siitonen S, Ollgren J, Pylkkänen L, Vasankari T. Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study. BMJ Open 2021; 11:e050502. [PMID: 34521671 PMCID: PMC8442068 DOI: 10.1136/bmjopen-2021-050502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men. DESIGN Cross-sectional questionnaire study. SETTING Three out of 16 Finnish Defence Forces units. PARTICIPANTS 1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling. PRIMARY AND SECONDARY MEASURES The prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined. RESULTS Almost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure. CONCLUSION Snus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.
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Affiliation(s)
- Maria Danielsson
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
- Doctoral Programme in Population Health, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Tarja Tanner
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Pertti Patinen
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Dowen Birkhed
- Former: Department of Cariology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Anelma Lammi
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
| | - Simo Siitonen
- The Defence Command, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Jukka Ollgren
- Department of Infectious Disease Surveillance and Control, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Liisa Pylkkänen
- Finnish Medicines Agency Fimea, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Oncology, University of Turku, Turku, Varsinais-Suomi, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Varsinais-Suomi, Finland
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