title: Snus user identity and addiction: a Swedish focus group study on adolescents.
abstract: BACKGROUND
  The teenage years are the years when adolescents seek their identity, and part of this involves experimenting with tobacco. The use of tobacco as such, and norms among their friends, is more important to the adolescents than the norms of parents when it comes to using tobacco or not. The aim was to explore the significance of using snus for adolescents, and attitudes to snus, as well as the reasons why they began using snus and what maintained and facilitated the use of snus.
  
  
  METHODS
  Adolescents who use snus were interviewed in focus groups. The material was analysed using content analysis.
  
  
  RESULTS
  Four groups of boys and one group of girls were interviewed, a total of 27 students from the upper secondary vocational program. Three themes related to the students' opinions on and experiences of using snus were found: Circumstances pertaining to snus debut indicate what makes them start using snus. Upholding, which focuses on the problem of becoming addicted and development of identity, and approach, where the adolescents reflect on their snus habits in relation to those around them. A number of factors were described as relevant to behaviour and norm building for the development into becoming a snus user. Attitudes and actions from adults and friends as well as - for the boys - development of an identity as a man and a craftsman influenced behaviour.
  
  
  CONCLUSIONS
  The results showed that development of identity was of major importance when adolescents start using snus. The adolescents were initially unable to interpret the early symptoms of abstinence problems, but subsequently became well aware of being addicted. Once they were stuck in addiction and in the creation of an image and identity, it was difficult to stop using snus. These factors are important when considering interventions of normative changes and tobacco prevention in schools as well as among parents.
authors.affiliation: Department of Clinical Sciences, Malmö, Family medicine, Lund University, Malmö, Sweden. ingrid.edvardsson@ltkronoberg.se
authors.forename: Ingrid
authors.initials: I
authors.lastname: Edvardsson
authors.forename: Margareta
authors.initials: M
authors.lastname: Troein
authors.forename: Göran
authors.initials: G
authors.lastname: Ejlertsson
authors.forename: Lena
authors.initials: L
authors.lastname: Lendahls
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D036301:Qualitative Research; D012307:Risk Factors; D012933:Social Identification; D012945:Social Values; D013548:Sweden; D014029:Tobacco Use Disorder / Q000523:psychology*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*