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    What drives the willingness to quit cigarette or snus use among young males?

    What drives the willingness to quit cigarette or snus use among young males?


    Considering the health hazards of smoking, a recent Scientific Reports study investigated the factors that enhance the willingness of young males to quit snus and cigarette smoking.

    Study: Factors predicting willingness to quit snus and cigarette use among young males. Image Credit: Finn-b/Shutterstock.comStudy: Factors predicting willingness to quit snus and cigarette use among young males. Image Credit: Finn-b/Shutterstock.com

    Background

    Nicotine is a naturally produced alkaloid compound that causes addiction among smokers. The development of nicotine addiction is a complex process influenced by multiple factors, such as duration of nicotine exposure, quantity of nicotine consumed, educational factors, genetic predisposition, and socioeconomic factors.

    Although the prevalence of tobacco smoking has decreased globally, only six European countries have reached the WHO Global Action Plan of a 30% reduction of tobacco use in any form by 2025. Tobacco industries have introduced alternative tobacco and nicotine products in response to the reduced popularity of smoking.

    For instance, snus, a Swedish type of smokeless tobacco, increased significantly among the younger population, particularly those living in the Northern European countries and the US.

    Compared to females, an increased smoking rate or use of any form of tobacco products has been observed among males in Sweden and Norway. A similar trend was recorded in Finland in 2021. 

    Previous studies have indicated that increased awareness about smoking-related health hazards enhanced the motivation to stop smoking completely. Although some documents on the preferred smoking cessation methods are available, no documents related to snus cessation approaches are available.

    Similar to smoking, snus use also increases consumers’ overall mortality and morbidity. Since the bioavailability of snus is high, a higher absorption of nicotine occurs, which is proportionate to the duration for which snus is kept buccally in the oral cavity.

    Although the Finnish Institute for Health and Welfare has developed a six-question questionnaire to assess snus dependence in Finland, this approach is not popularly applied in daily clinical practice. There is a need for a user-friendly approach to determine the extent of snus use.

    About the study

    The current study aimed to determine the factors that drive the willingness of young smokers and snus users to quit their habit.

    Male and female conscripts of Finnish Defence Forces units, who were at the beginning of their military service, were recruited. However, due to the low number of female conscripts, they were excluded from this study.

    A total of 6,508 male conscripts were recruited by random sampling method. Around 72% of the participants answered the questionnaire, which enquired about age, gender, use of snus, cigarettes, and electronic cigarettes, and educational background (e.g., comprehensive, vocational, and upper secondary education). The participants were also asked about the starting age of daily smoking and snus use.

    Smokers or snus users were divided into four groups, i.e., daily, former, occasional, or never. The duration of smoking or snus use was estimated based on the current age of the smokers and the starting age of smoking/snus use. The number of quit attempts was also recorded.

    The level of nicotine dependency was assessed based on the two-question test, namely, the Heaviness of Smoking Index (HSI), which categorized nicotine dependence into four categories, i.e., low, moderate, strong, and very strong.

    Study findings

    The mean age of the respondents was 19.4 years. The prevalence of daily snus use and smoking in the study cohort was estimated at 35% and 17%, respectively.

    The current multivariate analyses indicated that willingness to quit snus use was robustly associated with the perception of snus-related health hazards and earlier quit attempts. 

    An important factor driving the willingness to quit snus use or smoking is getting advice to quit. Like smokers, knowledge about health hazards increased the desire to quit snus. An increased dependence on these products has been inversely associated with quitting.

    A similar level of dependence was observed for smokers and snus users. Around 50% of the daily snus users and smokers reported low nicotine dependence, while 25% indicated strong or very strong dependence.

    Notably, both snus use and cigarette smoking were found to be equally popular, i.e., 35% of the cohort were snus users, and 38% were smokers.

    Unlike smoking, no association between snus use and educational background was observed. However, socioeconomic factors related to higher education prevent excessive use of cigarettes.

    Interestingly, almost half the population of daily snus users and smokers were willing to quit using the tobacco product. This desire was not linked to educational background.

    Although the majority of daily smokers recognized smoking as a harmful habit, only half the population of snus users considered it to be harmful. The willingness to quit snus use is strongly dependent on the perceived harmfulness of the product.

    Conclusions

    In Finland, smoking and snus use are very common in young males. The current study’s findings strongly indicate the lack of information about the adverse effects of snus use among the younger population.

    Unlike smoking, the increase in snus users was not linked to educational background. Therefore, increasing awareness about the adverse effects of snus use could significantly reduce the number of users.



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