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. 2022 Jan 7;19(2):683.
doi: 10.3390/ijerph19020683.

Single, Dual, and Triple Use of Cigarettes, e-Cigarettes, and Snus among Adolescents in the Nordic Countries

Kirsimarja Raitasalo  1 , Elin K Bye  2 , Charlotta Pisinger  3   4   5 , Janne Scheffels  2 , Rikke Tokle  2   6 , Jaana M Kinnunen  7 , Hanna Ollila  1 , Arja Rimpelä  7   8
Affiliations

Single, Dual, and Triple Use of Cigarettes, e-Cigarettes, and Snus among Adolescents in the Nordic Countries

Kirsimarja Raitasalo et al. Int J Environ Res Public Health. .

Abstract

New tobacco and nicotine products have emerged on the market in recent years. Most research has concerned only one product at a time, usually e-cigarettes, while little is known about the multiple use of tobacco and nicotine products among adolescents. We examined single, dual, and triple use of cigarettes, e-cigarettes, and snus among Nordic adolescents, using data of 15-16-year-olds (n = 16,125) from the European School Survey Project on Alcohol and other Drugs (ESPAD) collected in 2015 and 2019 from Denmark, Finland, Iceland, Norway, Sweden, and the Faroe Islands. Country-specific lifetime use of any of these products ranged between 40% and 50%, and current use between 17% and 31%. Cigarettes were the most common product in all countries except for Iceland, where e-cigarettes were remarkably more common. The proportion of dual and triple users was unexpectedly high among both experimental (24%-49%) and current users (31-42%). Triple use was less common than dual use. The users' patterns varied somewhat between the countries, and Iceland differed substantially from the other countries, with a high proportion of single e-cigarette users. More knowledge on the patterns of multiple use of tobacco and nicotine products and on the potential risk and protective factors is needed for targeted intervention and prevention efforts.

Keywords: Nordic countries; cigarettes; electronic cigarettes; multiple use; snus.

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Conflict of interest statement

The authors declare no conflict of interest. The Nordic Cancer Union or the other funding agencies had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Proportions of students with experimental or current use of at least one tobacco or nicotine product, by country.
Figure 2
Figure 2
Percentages of lifetime single, dual, and triple use of cigarette, e-cigarette, and snus among current and experimental users, by country.
See this image and copyright information in PMC

References

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