Smokeless tobacco (snus) use and its correlates among men during 2000-2020 in Finland
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Finnish Institute for Health and Welfare, Helsinki, Finland
Otto Ruokolainen   

Finnish Institute for Health and Welfare, Helsinki, Finland
Publication date: 2023-04-25
Tob. Prev. Cessation 2023;9(Supplement):A50
In Finland, the sale of snus is prohibited but (il)legal imports are common. Smoking has decreased for decades, but the use of snus has increased among adolescents. Less is known about the trends and correlates of snus use among the adult population. This study aimed to fill this gap.

Material and Methods:
Fourteen repeated cross-sectional surveys during the years 2000-2020 (including the years 2000–2005, 2008, 2010–2014, 2018, and 2020) with comparable measures were utilised. Total sample size was 181,000 and the response rate decreased from 69% in 2000 to 46% in 2020. Analyses were restricted to men aged 20–64 years (n = 24,404). The outcome was current (daily+occasional) snus use (yes/no) and main explanatory variable smoking status. Analyses included logistic regression model. Post-stratification weights were used to correct the effects of non-response.

Current snus use increased from 4.4% in 2000–2005 to 10.8% in 2018 and 2020. Compared with non-smokers, occasional smokers (OR 2.75, 95% CI 1.91–3.95) had higher odds for current snus use. The statistically non-significant associations were in the same direction for daily smokers and former smokers. Interaction of smoking status and time (p<0.0001) showed elevated risk for snus use in 2018–2020 for daily, occasional, and former smokers compared with non-smokers. Current snus use risk was higher also for those with younger age, intermediate educational level, being single, and binge drinking.

Snus use has increased over time among adult population. Occasional smoking is a risk factor for snus use, in addition especially to younger age and binge drinking. Regulative measures to curb the use of snus should be enacted to meet the objective of a tobacco- and nicotine free society by 2030. Additionally, motivating and helping snus users to stop should be increased in health care settings. These services should be targeted especially for young men and those with binge drinking.

The authors have no conflicts of interest to declare.