Changing patterns of tobacco use in a middle-aged population – the role of snus, gender, age, and education

• Published in: Global Health Action
• Main Authors: Margareta Norberg, Gunnar Lundqvist, Maria Nilsson, Hans Gilljam, Lars Weinehall
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2011
• Subjects: tobacco; prevalence; smoking; smokeless tobacco; Swedish moist snuff; snus; socioeconomic factors/education; Public aspects of medicine; RA1-1270; Northern Sweden
• Online Access: https://doi.org/10.3402/gha.v4i0.5613; https://doaj.org/article/c9a859d7d7024dfa8edb32d0d132e621

Background : In Sweden, the smoking prevalence has declined. In 2007, it was among the lowest in the industrialized world. A steady increase in the use of Swedish oral moist snuff, snus, has occurred in parallel. This development is neither solicited by authorities nor the medical establishment, but rather has occurred along with increased awareness of the dangers of smoking, and has been promoted by product development and marketing of snus. Objective : To evaluate time trends in patterns of tobacco use in northern Sweden during 1990–2007. Design : Cross-sectional (99,381 subjects) and longitudinal (26,867 subjects) data from the Västerbotten Intervention Programme (VIP) 1990–2007 were analyzed. All adults in Västerbotten County are invited to a VIP health examination at ages 40, 50, and 60 years, and until 1995 also 30 years. Smoking and use of snus were evaluated by gender, age and educational groups. Intermittent smoking was categorized as smoking. Results : From the period 1990–1995 to the period 2002–2007, smoking prevalence decreased from 26 to 16% among men and from 27 to 18% among women. The differences in prevalence increased between educational groups. The decline in smoking was less and the increase of snus use was greater among those with basic education. The use of snus among basic-educated 40-year-olds reached 35% among men and 14% among women during 2002–2007. Dual smoking and snus use increased among men and women with basic education. Smoking without snus use was more prevalent among women. Gender differences in total smoking prevalence (smoking only plus dual use) were small in all age groups, but increased among those with basic education reaching 7.3% during 2002–2007, with women being more frequent smokers. Smoking prevalences were similar among never, former and current snus users. Among the 30,000 former smokers, 38% of men and 64% of women had never used snus. Longitudinal data showed a decline in ...