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Adolescent snus use in Finland in 1981-2003: trend, total sales ban and acquisition
Heini S A Huhtala1, Susanna U Rainio, Arja H Rimpelä
1School of Public Health, 33014 University of Tampere, Tampere, Finland. Heini.Huhtala@uta.fi
Objective:
To study changes in adolescent snus use from 1981 to 2003, the effects of the total snus sales ban (1995) and snus acquisition.
Design:
Biennial postal surveys in 1981-2003.
Setting And Participants:
Entire Finland; 12-, 14-, 16-, and 18-year-olds (n = 73,946; 3105-8390 per year).
Main Outcome Measures:
Snus use (experimental, daily/occasionally), snus acquisition (2001, 2003).
Results:
Snus experimentation grew in popularity before the total sales ban in 16- and 18-year-old boys and after the ban in all age and sex groups. A decrease was seen between 2001 and 2003, except for 18-year-old boys. Daily/occasional use mainly followed the same pattern in boys while in girls the daily/occasional use was rare and no significant changes were observed. In 2003, boys experimented with snus more often than girls (12-year-olds 1% v 0%, 14-year-olds 9% v 4%, 16-year-olds 30% v 12%, 18-year-olds 44% v 18%). Hardly any girls used snus daily/occasionally, but 1% of 14-year-old boys, 7% of 16-year-olds, and 9% of 18-year-olds did. Of daily/occasional users, 84% acquired snus from friends or acquaintances, 55% from tourist trips to neighbouring countries (Estonia, Sweden), and 7% through sport teams; 24% obtained it from under-the-counter sources. For experimenters, the corresponding figures were 79%, 18%, 0.3%, and 5%.
Conclusions:
The total sales ban did not stop snus use; instead, the increase continued after the ban. Friends who travel to neighbouring countries act as go-betweens reselling snus. Snus is used even by the youngest adolescents, thus contributing to the nicotine dependence process.
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