Factors predicting willingness to quit snus and cigarette use among young males.

The health hazards of smoking are well recognised and recently knowledge about the harmful effects of nicotine and snus is accumulating. We investigated the factors increasing the willingness of young Finnish males to quit snus and cigarette smoking. We conducted a questionnaire study conducted in 3 out of 16 Finnish Defence Forces units which included 6508 male conscripts, of whom 4706 responded (response rate 72%, mean age 19.4 years). Factors related to the willingness to quit use were analysed by ordinal regression models. Backward selection following the Akaike information criterion (AIC) was used for the model. The prevalence figures of daily snus use and smoking were 17% and 25%, respectively. 16% of the daily snus users were also daily smokers and 29% were occasional smokers. Multivariate analysis showed that the willingness to quit snus use was associated with the perception of health hazards (OR 3.09, 95% CI 1.94-4.93) and with ≥ 2 quit attempts (OR 3.63, 95% CI 2.44-5.40). The willingness to quit smoking was associated with ≥ 2 quit attempts (OR 3.22, 95% CI 2.32-4.49), and with advice to quit smoking (OR 1.65, 95% CI 1.17-2.32). We created a brief two-question assessment model for snus dependence. With this model, nicotine dependence of daily snus users was congruent with that of nicotine dependence of smokers. A direct comparison with serum cotinine levels is necessary before our assessment model can be used as a proxy for dependence. Regular snus use predisposes to nicotine addiction and accumulated health hazards. Our findings underscore the importance of health promotion efforts in early adolescence and of active support for quitting snus use. Easily applicable tools to estimate nicotine addiction are needed for everyday clinical use.

Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study.

OBJECTIVE: The health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men. DESIGN: Cross-sectional questionnaire study. SETTING: Three out of 16 Finnish Defence Forces units. PARTICIPANTS: 1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling. PRIMARY AND SECONDARY MEASURES: The prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined. RESULTS: Almost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure. CONCLUSION: Snus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.

Alarming development of dual snus and cigarette usage among young Finnish males.

BACKGROUND: The consumption of tobacco products has evolved to include more complex combinations of different products. We investigated the tobacco habits of a representative population of young Finnish male conscripts in order to evaluate the prevalence of dual use of cigarettes and snus as well as the transition from one tobacco product to another. In addition, we evaluated the correlation between the level of education and the use of cigarettes and snus. METHODS: A questionnaire-based survey was carried out in three out of 17 garrisons among conscripts during their first week of service in 2014. A total of 1971 male conscripts were selected by simple random sampling of the 9013 males in the selected garrisons. Of them 1916 participated and filled in the questionnaire. The response rate was 97.2%. The questionnaire consisted of 25 questions including age, gender, basic education, use of tobacco products as well as questions assessing nicotine dependency. RESULTS: The amount of dual users of cigarettes and snus was 21%. There was a higher probability of dual use of cigarettes and snus among smokers compared to snus users (p < 0.001). One third (35%) of former smokers reported daily snus use and over 40% of the former snus users smoked daily. One third (34%) of the participants reported snus usage and 14% of the study subjects used snus daily. 40% of the study population were smokers and over 25% smoked daily. Of the participants with basic educational background 57% smoked daily (p < 0.001), however, no association between snus and level of education was found (p = 0.69). CONCLUSIONS: This study provides better understanding of the complex tobacco habits of young adult males. The simultaneous usage of multiple tobacco products as well as the high tendency to transition from one tobacco product to another should be taken into consideration when planning cessation interventions in health care settings and tobacco control policies at societal levels.

Unaltered blood coagulation and platelet function in healthy subjects exposed to acute hypoxia.

INTRODUCTION: Acute hypoxia has been suspected to cause blood coagulation and platelet activation. Our aim was to study blood coagulation and platelet function during a short hypoxic exposure. METHODS: Healthy nonsmoking men (N = 10) inhaled a normobaric hypoxic gas mixture containing 8% of oxygen (92% nitrogen) for 7 min via a face mask. Venous blood was collected 5 min before and during the 5 to 7 min of hypoxia exposure (i.e., pretest and hypoxia samples, respectively) while monitoring arterial oxygen saturation (SaO2) with pulse oximetry. Blood sampling was completed in 2 min and the face mask was removed. Venous epinephrine and norepinephrine, complete blood counts, and a panel of coagulation markers were analyzed. Platelet aggregation induced by ristocetin, adenosine diphosphate (ADP), arachidonic acid, and thrombin receptor activating peptide was studied with Multiplate and shear force-dependent functions with PFA-100R (collagen/epinephrine and collagen/ADP cartridges), both assays in whole blood. RESULTS: During hypoxia, SaO2 declined from 98 to 58% (ranges 97-99% vs. 42-85%), while heart rate increased from 69/min to 94/min (SD 11 vs. SD 13). Venous epinephrine and norepinephrine levels also increased. This short hypoxia induced minor but uniform increases in red cells, reticulocytes, and leukocytes and decreases in platelet counts. Plateletfunctions and prothrombin time, APTT, thrombin time, D-dimer, fibrinogen levels or von Willebrand factor (VWF), antithrombin, factor V (FV) or FVIII activities did not change. DISCUSSION: Profound acute hypoxia failed to affect blood coagulation or platelet functions in healthy individuals.