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Research papers: B Rodu, S Nasic, and P Cole Tobacco use among Swedish schoolchildren Tob Control 2005; 14: 405-408 [Abstract] [Full text] [PDF]

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Smokers who use oral snuff – are they non-smokers?

Paul Nordgren   (2 December 2005)

Smokers who use oral snuff – are they non-smokers? 2 December 2005
Paul Nordgren National Institute of Public Health, Sweden Send letter to journal: Re: Smokers who use oral snuff – are they non-smokers? paul.nordgren{at}fhi.se Paul Nordgren	In the latest issue of Tobacco Control, Radu and others report on tobacco use among Swedish schoolchildren (Tobacco Control 2005;14:405- 408). As a Swede, I was surprised to read about some of their findings. Children who smoke daily or almost daily are defined as “regular smokers”. The percentage of regular smokers is reported to have decreased to 4 per cent among 16-years-old boys and 15 per cent among girls by 2003. These figures differ significantly from the data found in the original (Swedish) reports from the CAN (Swedish Council for Information on Alcohol and Other Drugs). According to the latest CAN report (2005) the percentage of “regular smokers” in 2003 was 7 per cent among boys and 13 per cent among girls. So, how can the authors reach the figure 4 per cent for boys? One explanation, which can be hypothesized from Figure 2 in the paper, may be that “regular smokers” who also use oral snuff, have been excluded from the category of “regular smokers”. If this is the case, I find this to be a highly innovative method of presenting data in order to make them support one’s favourite, preconceived conclusions. Smokers who also use oral snuff – are they not smokers? The “gender gap” in tobacco habits certainly exists – it has been there ever since the early 1970s, when this series of surveys was started and the use of oral snuff was practically non-existent among boys. The main explanation for this gap seems to be the fact that 16-year-old girls are – biologically and socially – more “grown-up” than boys of the same birth cohort. Additional explanations may of course exist – tobacco initiation is a complex development where several social, psychological and other influences are active. During the last few years there has been a marked decrease of regular smoking among both boys and girls. At the same time, regular use of oral snuff has also decreased among boys. To reach – from these data – the conclusion that “snus use suppresses smoking among boys”, appears to be a daring exercise. To me, the jump is far to big. Paul Nordgren National Institute of Public Health, Stockholm, Sweden paul.nordgren@fhi.se