title: Snuff use and smoking among senior high school students: effects of a snuff sales ban.
abstract: OBJECTIVE
  The popularity of snuff especially among adolescents is rising. The association between long-term snuff use and oral cancer discovered in epidemiological studies has prompted a variety of preventive measures to be taken to reduce snuff use and prevent adoption of the habit. In this study, the effect of a recent (1 March, 1995) snuff sales ban introduced in Finland was investigated. Further, the rates of smoking, snuff use, alcohol use and drug experimenting were investigated before the introduction of the ban to characterize the study population.
  
  
  METHODS
  Two questionnaire studies were carried out. The first was carried out 3 months prior to the ban in 1994 and the second 9 months after the ban in 1995 in a senior high school population in southwestern Finland. The participants were 793 students (aged 15-22 years) in the first survey and 545 students (aged 16-23) in the second. Associations between variables were analyzed using cross-tabulation and step-wise logistic regression. The effects of the ban were determined on the basis of direct questions in the second questionnaire relating to the snuff sales ban.
  
  
  RESULTS
  Snuff was used by 9% of the students participating in the first study. The results of the second questionnaire indicate that the implementation of the snuff sales ban reduced the rate of snuff use by 1% in the study population. The majority of the snuff users (76%) reported that they had maintained their snuff habit. Of those reporting that they were snuff users before implementation of the snuff sales ban, 12% had switched to smoking and 5% to drugs.
  
  
  CONCLUSIONS
  The results of the present study suggest that the snuff sales ban in this population with a high rate of snuff use had little effect on snuff use rates and may have some short-term negative consequences as some snuff users switch to other substitutes, such as smoking, with known adverse health effects.
authors.affiliation: Department of Oral Pathology and Radiology, Faculty of Medicine, University of Turku, Finland. marina.merne@utu.fi
authors.forename: M E
authors.initials: ME
authors.lastname: Merne
authors.forename: J T
authors.initials: JT
authors.lastname: Tiekso
authors.forename: S M
authors.initials: SM
authors.lastname: Syrjänen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005387:Finland; D006293:Health Promotion / Q000331:legislation & jurisprudence; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010947:Plants, Toxic; D012907:Smoking / Q000523:psychology; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden; D019460:Tobacco Industry / Q000331:legislation & jurisprudence; D020340:Tobacco Use Cessation / Q000523:psychology; D014029:Tobacco Use Disorder / Q000523:psychology*; D014030:Tobacco, Smokeless / Q000191:economics