Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study
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 an...
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Online Access: | http://dx.doi.org/10.1136/bmjresp-2024-002401 https://syndication.highwire.org/content/doi/10.1136/bmjresp-2024-002401 |
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crjcrbmj:10.1136/bmjresp-2024-002401 2024-09-15T18:14:32+00:00 Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study López-Cervantes, Juan Pablo Schlünssen, Vivi Senaratna, Chamara Accordini, Simone Callejas, Francisco Javier Franklin, Karl A Holm, Mathias Jogi, Nils Oskar Malinovschi, Andrei Oudin, Anna Sigsgaard, Torben Thorarinsdottir, Elin Helga Janson, Christer Bertelsen, Randi Jacobsen Svanes, Cecilie The Danish Wood Foundation Bergen Medical Research Foundation Eesti Teadusagentuur Sociedad Española de Neumología y Cirugía Torácica Hjärt-Lungfonden National Health and Medical Research Council Arbejdstilsynet Háskóli Íslands University of Bergen Astma- och Allergiförbundet Norwegian Asthma and Allergy Association HORIZON EUROPE European Innovation Council Research Council of Norway University of Melbourne NAV Worldwide Universities Network Aarhus University European Research Council 2024 http://dx.doi.org/10.1136/bmjresp-2024-002401 https://syndication.highwire.org/content/doi/10.1136/bmjresp-2024-002401 en eng BMJ https://creativecommons.org/licenses/by/4.0/ BMJ Open Respiratory Research volume 11, issue 1, page e002401 ISSN 2052-4439 journal-article 2024 crjcrbmj https://doi.org/10.1136/bmjresp-2024-002401 2024-07-25T04:14:38Z 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. Article in Journal/Newspaper Iceland The BMJ BMJ Open Respiratory Research 11 1 e002401 |
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The BMJ |
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English |
description |
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. |
author2 |
The Danish Wood Foundation Bergen Medical Research Foundation Eesti Teadusagentuur Sociedad Española de Neumología y Cirugía Torácica Hjärt-Lungfonden National Health and Medical Research Council Arbejdstilsynet Háskóli Íslands University of Bergen Astma- och Allergiförbundet Norwegian Asthma and Allergy Association HORIZON EUROPE European Innovation Council Research Council of Norway University of Melbourne NAV Worldwide Universities Network Aarhus University European Research Council |
format |
Article in Journal/Newspaper |
author |
López-Cervantes, Juan Pablo Schlünssen, Vivi Senaratna, Chamara Accordini, Simone Callejas, Francisco Javier Franklin, Karl A Holm, Mathias Jogi, Nils Oskar Malinovschi, Andrei Oudin, Anna Sigsgaard, Torben Thorarinsdottir, Elin Helga Janson, Christer Bertelsen, Randi Jacobsen Svanes, Cecilie |
spellingShingle |
López-Cervantes, Juan Pablo Schlünssen, Vivi Senaratna, Chamara Accordini, Simone Callejas, Francisco Javier Franklin, Karl A Holm, Mathias Jogi, Nils Oskar Malinovschi, Andrei Oudin, Anna Sigsgaard, Torben Thorarinsdottir, Elin Helga Janson, Christer Bertelsen, Randi Jacobsen Svanes, Cecilie Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study |
author_facet |
López-Cervantes, Juan Pablo Schlünssen, Vivi Senaratna, Chamara Accordini, Simone Callejas, Francisco Javier Franklin, Karl A Holm, Mathias Jogi, Nils Oskar Malinovschi, Andrei Oudin, Anna Sigsgaard, Torben Thorarinsdottir, Elin Helga Janson, Christer Bertelsen, Randi Jacobsen Svanes, Cecilie |
author_sort |
López-Cervantes, Juan Pablo |
title |
Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study |
title_short |
Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study |
title_full |
Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study |
title_fullStr |
Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study |
title_full_unstemmed |
Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study |
title_sort |
use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based rhinessa study |
publisher |
BMJ |
publishDate |
2024 |
url |
http://dx.doi.org/10.1136/bmjresp-2024-002401 https://syndication.highwire.org/content/doi/10.1136/bmjresp-2024-002401 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
BMJ Open Respiratory Research volume 11, issue 1, page e002401 ISSN 2052-4439 |
op_rights |
https://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.1136/bmjresp-2024-002401 |
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BMJ Open Respiratory Research |
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11 |
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1 |
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e002401 |
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