Introduction:Given there are few experimental studies comparing the effects of snus and medicinal products for quitting smoking, self-reports from smokers who have used different methods for quitting smoking can be informative.Methods:Fourteen thousand seven hundred and forty-four Norwegian men aged between 20 and 50 years were selected at random from a national representative web panel and sent a questionnaire by E-mail. Of the 7,170 (48.6%) who responded, there were 1,775 former and 1,808 current smokers. They were asked about the method they used and the outcome of their last attempt to quit smoking.Results:In a regression model in which education, number of previous attempts to quit smoking, perception of risk, and age were controlled for, the odds ratio (OR) for reporting total abstinence at the time of the survey was significantly higher for those who had used varenicline (OR = 4.95, p < .006) and snus (OR = 2.68, p < .001) compared with those who had used nicotine chewing gum (reference OR = 1). For smokers who reported that they had tried to quit with the help of snus, 62.4% reported that they still used snus at the time of the survey either daily (43.8%) or occasionally (18.6%). The proportion who still used medicinal nicotine products at the time of the survey was 9.5%.Discussion:Compared with medicinal nicotine products, snus and varenicline increased the probability of quitting smoking completely, but snus seemed to maintain nicotine dependence.

The smoking habits in Norway appear to have been strongly influenced by social changes and the increasing awareness of the health hazards of smoking. Each cohort's response to these events has depended on the members' age and sex at the time.

Introduction:The aim of this study was to investigate changes in the relative proportion of hardcore smokers (HCS) in Norway for the years 1996–2009.Methods:Data were derived from Statistics Norway’s annually cross-sectional representative samples of the adult population. The total sample size of smokers each year was between 250 and 500. The outcome measure was HCS, defined by their intention not to quit smoking and absence of attempts to quit during the last 12 months. Logistic regression analysis was conducted to estimate the association between time (survey year) and the number of HCS.Results:We identified three groups of smokers: occasional smokers, daily non-HCS, and HCS. The relative proportion of HCS declined in the period 1996–2009, from 30% to 23%. A model adjusted for gender, age, educational level, and the use of snus (smokeless tobacco) showed the same downward trend.Conclusions:Within this sample of Norwegian smokers, the relative share of HCS is not increasing. This knowledge is important for tobacco prevention policy. The result does not support a hardening hypothesis regarding changes in the size of the group of HCS. Further analysis is needed to investigate individual resistance to smoking cessation.

AimSwedish studies have shown that experience of using snus is associated with an increased probability of being a former smoker. We examined whether this result is also found in Norway.DesignSeven cross-sectional data sets collected during the period 2003–08.SettingNorway.ParticipantsA total of 10 441 ever (current or former) smokersMeasurementsQuit ratios for smoking were compared for people with different histories of snus use. Motive for snus use was examined among combination users (snus and cigarettes). Smoking status was examined among snus users.FindingsCompared to smokers with no experience of using snus, the quit ratio for smoking was significantly higher for daily snus users in six of seven data sets, significantly higher for former snus users in two of five data sets and significantly lower for occasional snus users in six of seven data sets. Of combination users who used snus daily, 55.3% [confidence interval (CI) 44.7–65.9] reported that their motive for using snus was to quit smoking totally. This motive was reported significantly less often by combination users who used snus occasionally (35.7%, CI 27.3–44.2). Former smokers made up the largest proportion of daily snus users in six of seven data sets. In the remaining data set, that included only the age group 16–20 years, people who had never smoked made up the largest segment of snus users.ConclusionsConsistent with Swedish studies, Norwegian data shows that experience of using snus is associated with an increased probability of being a former smoker. In Scandinavia, snus may play a role in quitting smoking but other explanations, such as greater motivation to stop in snus users, cannot be ruled out.

Introduction:We examine the prevalence of dual use of snus and cigarettes among Norwegian men by categorizing dual use into four categories according to the frequency of use of each product, considering the order of uptake of both products, and examining reasons for additional snus use. We compare dual users and exclusive cigarette smokers with respect to their smoking intensity, plans for quitting smoking, and future smoking identity.Methods:We used a data pool of six cross-sectional, national representative surveys conducted annually in the period 2005–2010 containing a total of 3,524 males aged 16–74.Results:6.8% of men had some kind of current concomitant use of snus and cigarettes—but only 1% reported a daily consumption of both products. The most typical pattern of dual use was a combination where daily use of one product was paired with occasional use of the other. Dual users consumed significantly fewer cigarettes per week (56.6; n = 226; SD, 53.82) than smokers who had either quit snus (79.6; n = 108; SD, 61.47) or single smokers with no history of snus use (80.2; n = 621; SD, 55.86). Only 24% with a history of dual use reported snus to be their first tobacco product, but the proportion who had initiated tobacco use with snus increased significantly with younger age. Among dual users with daily intake of snus, a majority of 53.6% reported that the purpose of their snus use was to quit smoking. A higher proportion of dual users (74.4%; 95% CI, 68.8–80.0; n = 235) than exclusive smokers (61.3%; 95% CI, 57.6–65.0; n = 658) reported that they most definitely or probably would be totally smoke-free 5 years into the future.Conclusions:In the mature snus market of Norway, the magnitude of dual use of cigarettes and snus is relatively small. Dual users consume fewer cigarettes, and a higher proportion portray themselves as smoke-free in the future than do exclusive cigarette smokers.

Quitlines are effective as an adjunct to the health care system. For women a proactive treatment may be more effective than a reactive treatment.

The main barriers identified in this study indicate that smoking cessation expertise needs to be more accessible. One alternative is to establish telephone help-lines (Quit-lines) that are easily available for all and could serve as a back-up for the GPs. Another more costly approach is to develop smoking cessation expertise at major clinics. A combination of both is probably the best solution.

The main barriers identified in this study indicate that smoking cessation expertise needs to be more accessible. One alternative is to establish telephone help-lines (Quit-lines) that are easily available for all and could serve as a back-up for the GPs. Another more costly approach is to develop smoking cessation expertise at major clinics. A combination of both is probably the best solution.