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Associations between adolescent socioeducational status and use of snus and smoking
  1. Simon Øverland1,
  2. Tore Tjora1,2,
  3. Jørn Hetland3,
  4. Leif Edvard Aarø1,4
  1. 1Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
  2. 2Unifob Health, Bergen, Norway
  3. 3Faculty of Psychology, University of Bergen, Bergen, Norway
  4. 4Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
  1. Correspondence to Simon Øverland, Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Christiesgate 13, Bergen 5015, Norway; simon.overland{at}


Background Findings from studies on the association between smoking and socioeconomic status are mixed. While adolescent smoking is reduced in many countries, use of smokeless tobacco seems to increase. Associations between socioeducational status and smoking as well as use of snus (smokeless tobacco), and to what extent these associations had changed significantly from 2004 to 2007 (a period of relatively abrupt changes in tobacco use in Norway), were examined.

Methods Data from two national representative cross-sectional studies of Norwegian 16–20 year olds, where participants were asked questions allowing us to construct indicators of socioeducational status, was used. Information was also collected about the adolescents' smoking and use of snus, as well as their intentions with regard to future use of these products.

Results Adolescents with a lower socioeducational status had much higher odds for smoking compared to those with higher socioeducational status (ORs ranged from 2.9 to 3.8). There was no similar association between socioeducational status and snus use (ORs ranged from 0.6 to 1.2). No support was found for a change in the socioeducational status–smoking/snus use association from 2004 to 2007.

Conclusions Adolescents' socioeducational status was associated with smoking for boys and girls, while there was no similar association with snus use. This may indicate that snus truly deviates from how smoking is distributed across social strata or that snus is at a much earlier stage in the social diffusion process.

  • Socioeconomic status
  • socioeducational status
  • smoking
  • smokeless tobacco
  • adolescents
  • nicotine products
  • smokeless tobacco products
  • young adults

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  • Funding Funding was received from the Norwegian Directorate for Health.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The study protocol was presented for the Regional Committee for Medical Research Ethics (REK-Vest), and was carried out within the general permits of Synovate MMI Inc. The sample of participants was drawn from the Norwegian Population Registry with approval from the Norwegian Tax Administration.

  • Provenance and peer review Not commissioned; externally peer reviewed.