title: Dual use of cigarettes and Swedish snuff (snus) among young adults in Northern Finland.
abstract: BACKGROUND
  The sale of smokeless tobacco has been totally banned in Finland since the country joined the European Union in 1995. Adolescents have continued to use smokeless tobacco even after the sales ban. The objective was to describe dual use of Swedish snuff (snus) and cigarettes in young adults living in Northern Finland.
  
  
  METHODS
  This study on male military recruits (n = 1151, mean age 19.4 years; response rate 80%) investigated association of snus use with self-reported tobacco use, nicotine dependence and attempts to quit smoking.
  
  
  RESULTS
  Overall, 15.6% (n = 179) reported daily snus use, and almost half of them were dual users who used both products, i.e. cigarettes and snus, daily. Daily smokers were often occasional snus users (66.3%), and those with dual use smoked equal number of cigarettes per day as daily smokers who were not snus users. In addition, dual snus use seemed to increase the dependence to cigarettes, although this trend did not reach statistical significance. Dual users tried to quit less likely than exclusive smokers. Very few snus users were 'switchers' (ex-smokers) [3.2% (n = 22) of all snus users].
  
  
  CONCLUSIONS
  Dual use of snus and cigarettes is common among young in Finland, despite the sales ban on snus. The role of snus in reducing cigarette smoking is unclear, but it is likely that snus use complicates the attempts to quit smoking.
authors.affiliation: 1 Department of Medicine, Pulmonary Division, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Hamari
authors.forename: Tuula I
authors.initials: TI
authors.lastname: Toljamo
authors.forename: Vuokko L
authors.initials: VL
authors.lastname: Kinnula
authors.forename: Pentti A
authors.initials: PA
authors.lastname: Nieminen
mesh_terms: D000293:Adolescent; D000328:Adult; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless / Q000009:adverse effects / Q000706:statistics & numerical data*; D055815:Young Adult