Use of Tobacco and Nicotine Products among Young People in Denmark—Status in Single and Dual Use

Abstract

Lots of new tobacco or nicotine products are being launched, e.g., e-cigarettes and smokeless tobacco, which appeal especially to the youngest part of the population. For example, the use of smokeless tobacco among Danish youth rose from approx. 2% in 2010 to 9% in 2020. Hence, there is an urgent need to follow and intervene against youth tobacco or nicotine product use. This study explored the current use of cigarettes, e-cigarettes, heated tobacco, and smokeless tobacco among Danish 15- to 29-year-olds. Further, we examined the concurrent use of two products or more. We used a nationwide survey conducted among 15- to 29-year-olds in February and March 2020. Overall, approx. 35,700 individuals received the questionnaire of which 35.5% responded (n = 13,315). One out of five (20.1%) smoked cigarettes, half of them daily, the other half occasionally. About one in twenty (3.9%) used e-cigarettes (daily or occasionally), and more than one in three (31.6%) had tried e-cigarettes. The use of heated tobacco among Danish youth is still relatively limited (0.3%). In comparison, about 9% used smokeless tobacco (daily or occasionally). Overall, 27.0% stated that they use at least one type of tobacco or nicotine product, while 5.6% used more than one product. Monitoring tobacco-related behavior in youth provides extremely important information for, e.g., policymakers and health professionals.

Use of tobacco, nicotine and cannabis products among students in Switzerland

“…Because ours was the first Swiss study to detail use prevalence of most available tobacco and nicotine products among 15-21-year-olds, we can only speculate about use trends. Our results align with earlier studies from Switzerland, Germany, and Denmark that found adolescents were more likely to smoke tobacco cigarettes than use any other products (13)(14)(15)(16)(17). While the 2017 Swiss National Health Survey (SNHS) found 10.7% of Swiss youth smoked daily, we found smoking prevalence was higher (14.2%).…”

“…Like other studies, we found use of tobacco burning products increases with age ( 13 , 14 , 23 ). Neurobiological studies indicate that younger people are more quickly addicted to substances ( 24 ), and in Switzerland youth may legally smoke tobacco at 16, while in most other countries the legal smoking age is 18 ( 25 ).…”

“…In Denmark, cigarette consumption among 15–24-year-olds is significantly lower than in Switzerland, as is occasional use (weekly or less than once a week) of e-cigarettes and smokeless tobacco products. Only reported daily prevalence of e-cigarettes and smokeless tobacco is similar in Switzerland and Denmark ( 14 ).…”

“…We found large gender differences in oral tobacco and nicotine product use. Men reported using oral products more often than women, though smoking patterns were similar ( 14 , 26 ). It is possible that social representations of masculinity, stimulus-seeking, and the practices of celebrity athletes (e.g, use of snus by many hockey players) contribute to difference in use between genders ( 26 ).…”

“…In countries like Switzerland, which are "tobacco industry friendly, " (12), health and prevention professionals need this data to persuade political decision makers to adopt policies that protect vulnerable populations. But few studies have described usage of these new tobacco, nicotine, and cannabis products in adolescents in Europe (8,(13)(14)(15)(16)(17) and we know of no study that assessed prevalence and frequency of use across the variety of products. We thus set out to ascertain prevalence and frequency of use of a broad range of tobacco, nicotine, and cannabis products by surveying students in Switzerland and determining associations between product use and socio-demographic factors such as age, gender, and school type.…”