title: Snuff use associated with abdominal obesity in former smokers.
abstract: OBJECTIVE
  To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity.
  
  
  METHODS
  Tobacco use was explored in 834 men aged 30-75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination.
  
  
  RESULTS
  Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08-3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08-2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05-2.36) (p = 0.041) waist circumference and 0.01 (0.00-0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users.
  
  
  CONCLUSIONS
  Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
authors.affiliation: Public Health Unit, City Council of Malmö, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Sundbeck
authors.forename: Mathias
authors.initials: M
authors.lastname: Grahn
authors.forename: Vincent
authors.initials: V
authors.lastname: Lönngren
authors.forename: Nils Ove
authors.initials: NO
authors.lastname: Månsson
authors.forename: Lennart
authors.initials: L
authors.lastname: Råstam
authors.forename: Ulf
authors.initials: U
authors.lastname: Lindblad
mesh_terms: D050153:Abdominal Fat; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012424:Rural Population; D016540:Smoking Cessation; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014030:Tobacco, Smokeless; D015430:Weight Gain