Adolescent snus use in Finland in 1981–2003: trend, total sales ban and acquisition

Objective: To study changes in adolescent snus use from 1981 to 2003, the effects of the total snus sales ban (1995) and snus acquisition. Design: Biennial postal surveys in 1981–2003. Setting and participants: Entire Finland; 12-, 14-, 16-, and 18-year-olds (n = 73 946; 3105−8390 per year). Main outcome measures: Snus use (experimental, daily/occasionally), snus acquisition (2001, 2003). Results: Snus experimentation grew in popularity before the total sales ban in 16- and 18-year-old boys and after the ban in all age and sex groups. A decrease was seen between 2001 and 2003, except for 18-year-old boys. Daily/occasional use mainly followed the same pattern in boys while in girls the daily/occasional use was rare and no significant changes were observed. In 2003, boys experimented with snus more often than girls (12-year-olds 1% v 0%, 14-year-olds 9% v 4%, 16-year-olds 30% v 12%, 18-year-olds 44% v 18%). Hardly any girls used snus daily/occasionally, but 1% of 14-year-old boys, 7% of 16-year-olds, and 9% of 18-year-olds did. Of daily/occasional users, 84% acquired snus from friends or acquaintances, 55% from tourist trips to neighbouring countries (Estonia, Sweden), and 7% through sport teams; 24% obtained it from under-the-counter sources. For experimenters, the corresponding figures were 79%, 18%, 0.3%, and 5%. Conclusions: The total sales ban did not stop snus use; instead, the increase continued after the ban. Friends who travel to neighbouring countries act as go-betweens reselling snus. Snus is used even by the youngest adolescents, thus contributing to the nicotine dependence process.