Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study

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Use of oral moist tobacco (snus) in puberty and its association with asthma in the population-based RHINESSA study

López-Cervantes, Juan Pablo (author): Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway

Schlünssen, Vivi (author): Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark

Senaratna, Chamara (author): Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne VCCC, VIC, Melbourne, Australia

Accordini, Simone (author): Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy

Callejas, Francisco Javier (author): Department of Respiratory Medicine, Albacete University Hospital Complex, Albacete, Spain

Franklin, Karl A. (author): Umeå universitet,Kirurgi,Institutionen för diagnostik och intervention

Holm, Mathias (author): Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden

Jõgi, Nils Oskar (author): Uppsala universitet,Klinisk fysiologi,Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden

Malinovschi, Andrei, 1978- (author): Uppsala universitet,Klinisk fysiologi,Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden

Oudin, Anna (author): Umeå universitet,Institutionen för folkhälsa och klinisk medicin

Sigsgaard, Torben (author): Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark

Thorarinsdottir, Elin Helga (author): Primary Health Care of the Capital Area, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland

Janson, Christer (author): Uppsala universitet,Lung- allergi- och sömnforskning,Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden

Bertelsen, Randi Jacobsen (author): Department of Clinical Science, University of Bergen, Bergen, Norway

Svanes, Cecilie (author): Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway

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2024-07-22
2024
English.
In: BMJ Open Respiratory Research. - : BMJ Publishing Group Ltd. - 2052-4439. ; 11:1

Related links:: https://doi.org/10.1...; show more...; https://uu.diva-port... (primary) (Raw object); https://umu.diva-por... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

OBJECTIVES: To investigate the association of early snus use initiation (≤15 years of age) with asthma and asthma symptoms.DESIGN: Cross-sectional analysis of a population-based cohort.SETTING: Study centres in Norway, Sweden, Iceland, Denmark and Estonia, from 2016 to 2019.PARTICIPANTS: 9002 male and female participants above 15 years of age of the Respiratory Health in Northern Europe, Spain and Australia study.MAIN OUTCOME MEASURES: Current asthma and asthma symptoms.RESULTS: The median age of study participants was 28 years (range 15-53) and 58% were women. 20% had used snus, 29% men and 14% women. Overall, 26% of males and 14% of females using snus started ≤15 years of age. Early snus use initiation was associated with having three or more asthma symptoms (OR 2.70; 95% CI 1.46 to 5.00) and a higher asthma symptom score (β-coefficient (β) 0.35; 95% CI 0.07 to 0.63) in women. These associations were weak in men (OR 1.23; 95% CI 0.78 to 1.94; β 0.16; 95% CI -0.06 to 0.38, respectively). There was evidence for an association of early snus initiation with current asthma (OR 1.72; 95% CI 0.88 to 3.37 in women; OR 1.31; 95% CI 0.84 to 2.06 in men). A sensitivity analysis among participants without smoking history showed stronger estimates for all three outcomes, in both men and women, statistically significant for three or more asthma symptoms in women (OR 3.28; 95% CI 1.18 to 9.10). Finally, no consistent associations with asthma outcomes were found for starting snus after age 15 years.CONCLUSIONS: Snus initiation in puberty was associated with higher likelihood of asthma and asthma symptoms, with the highest estimates in females and those without smoking history. These results raise concerns about the health adversities of early snus initiation and emphasise the need for public health initiatives to protect young people from this tobacco product.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa och socialmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health and Social Medicine (hsv//eng)

Keyword

Asthma
Asthma Epidemiology
Surveys and Questionnaires
Tobacco and the lung
Clinical Physiology
Klinisk fysiologi
Lungmedicin
Lung Medicine

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ref (subject category)
art (subject category)

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