BACKGROUND: During the last decades, the proportion of smokers has declined and the use of snus has increased. We examined changes in 16 - 20-year-olds' use of tobacco products after introduction of stricter smoking regulations in 2004. MATERIAL AND METHODS: 16 - 20-year-olds' use of and attitudes towards tobacco-products were assessed in national surveys representative for the age-group (n 2004 =2400 and n 2007 =2415) in 2004 and 2007. We compared use of such products at the two measurement points and to what extent the decline in smoking and increase in snus. RESULTS: The same proportion of adolescents used snus or smoked in both surveys (28.8 %), but the distribution was markedly changed. In 2004, 22.5 % of the girls and 20.3 % of the boys smoked daily or every week; corresponding figures in 2007 were 17.3 % and 17.0 %. In 2004, 18.2 % of the boys used snus daily or every week and in 2007 the proportion had increased to 24.9 %. Among the girls, this figure tripled between the two surveys, from 2.4 % to 7.3 %. INTERPRETATION: A further reduction in smoking rates can be expected if we presume that the changes we found are stable. The increased use of snus calls for more knowledge about how this product affects health.
BACKGROUND: Smoking and snuff habits among medical students are of interest because they may reflect the attitude to smoking and snuff among future doctors, but few longitudinal studies have been performed. MATERIAL AND METHOD: A standard questionnaire, developed by Statistics Norway, was handed out to all medical students at the University of Bergen during plenum lectures in the spring 2004 and 2006. The questionnaires were marked by personal codes to enable follow-up of smoking and snuff habits for each individual student during the study period. New questionnaires were sent by post to all students who did not respond after the initial handout. RESULTS: 799 medical students (89 %) responded in the spring 2004 and 789 students (84 %) in the spring 2006. The study revealed that 3 % of the students smoked regularly in 2004 and 1 % in 2006 and that 20 % were occasional smokers in 2004 and 18 in 2006. 15 % of the students were snuff users in 2004 and this had increased to 24 % in 2006. INTERPRETATION: A decrease was observed in both daily and occasional smokers among medical students in Bergen during the two-year study period. However, the frequency of snuff users increased. The frequency of regular smokers is low, but the number of occasional smokers is higher than in the general population of the same age.
BACKGROUND: Different prevalences of cigarette smoking and use of snus between University students and non-students, may supply us with information about the diffusion stage of the epidemic. User characteristics and involvement in other risk behaviour influences their status as diffusion agents. MATERIAL AND METHODS: 1 655 students at the University of Oslo responded to a postal questionnaire about their tobacco, alcohol and drug use, gambling habits, physical activity and incidence of anxiety and depression. Data on tobacco habits of similarly aged youth outside University were obtained from Statistics Norway. RESULTS: The response rate was 57 %. The proportion of daily smokers was significantly lower among students (men [10 %], women [9.6 %]), than among non-students (men [27 %], women [28 %]). The proportion of snuff users (daily + occasionally) for women was almost three times higher among students (12 %) than non-students (3.8 %). For men the results were different (28 % snuff users among students and 33 % among non-students). The quit-rate for smoking among students was higher for daily (46 %) and former users (61 %) of snus, than among students who had not used snus (34 %). Cigarette smoking increased with drug abuse, alcohol consumption, physical inactiveness, reduced mental health, and absence of parity. Use of snus was a typical male phenomenon, and increased with alcohol consumption and drug abuse. INTERPRETATION: The diffusion of the snus epidemic seems to be in an early stage for women, while for men it may already have reached a level of maturity. The high proportion of previous smokers among snus users, indicates that snus may affect the prevalence and frequency of smoking in a population. Groups with a low social impact seem to have a higher prevalence of smokers, both in general and among students, while the opposite is the case for snus users.
Little attention is given to occasional smoking compared with daily smoking. However, there are indications that there is a continuous increase in occasional smoking throughout the western world. In Norway, 33% of smokers do not smoke daily. Little is known about these smokers' background, how often they smoke, and how many cigarettes they consume when they do smoke. Studies indicate that occasional smokers seem to differ from regular smokers in their socio-demographic characteristics. In this article we show that a proportion of the occasional smokers smoke more than previously assumed. Therefore this smoking pattern may have greater implications for health than previously assumed and can no longer be ignored.
Lung cancer can be caused by occupational exposure. This is not always recognised or reported, and not all patients receive the benefits to which they are entitled.
We collected occupational case histories for patients from Sør-Trøndelag county with a first-time diagnosis of lung cancer. The number of reported cases of occupationally related lung cancer was collected from the Norwegian Labour Inspection Authority, and information on approval of occupational illness was collected from the Norwegian Labour and Welfare Authority (NAV).
105 patients with lung cancer took part in the study, 73 men and 32 women. Among the men, altogether 12 cases (16%) were assessed as likely and 16 (22%) as possibly occupationally related. Among the women, none of the cases were assessed as occupationally related. The reporting frequency from the health regions to the Norwegian Labour Inspection Authority varied from 1.7% to 5.1%. Altogether 9 out of 11 likely cases and 5 out of 12 possible cases of occupationally related lung cancer were granted injury compensation by the Norwegian Labour and Welfare Authority.
In this study, we found that approximately 20% of the cases of lung cancer in men are occupationally related, and that the underreporting of occupationally related lung cancer appears to be considerable. The obligation of doctors to report to the Norwegian Labour Inspection Authority should be made better known. Most likely, more patients would have had their lung cancer verified as an occupational illness and could have received injury compensation if they had been aware of the opportunity to apply for this.
Comment In: Tidsskr Nor Laegeforen. 2014 Oct 28;134(20):1916-725350419
BACKGROUND: The prevalence of smoking is decreasing. At the same time, studies suggest that the relative proportion of nicotine dependent smokers is increasing. This may leave us with a smaller, but more problematic group of smokers. Few studies have investigated nicotine dependence in Norway. MATERIAL AND METHODS: Data were collected in the Young in Norway Longitudinal Study, where 2,890 respondents were followed up from their early teens until their late 20s. Information was collected on smoking habits, nicotine dependence, education, various indicators of social marginalization, anxiety, depression, suicidal behaviour, alcohol problems and use of drugs. RESULTS: At the age of 28 years, 12 % (n = 357) were classified as non-dependent daily smokers, whereas 5 % (n = 148) fulfilled criteria for "weak" and 3 % (n = 93) for "strong" nicotine dependence. 74 % of those who were in the "strong" dependent group at age 22 were still daily smokers at age 28; versus 50 % of non-dependent smokers. Nicotine dependence was associated with weak social resources, reduced mental health, alcohol problems and use of illegal drugs. INTERPRETATION: Daily smokers are more or less nicotine dependent. Smokers with a strong dependency have more stable smoking habits, weaker social resources and more problems with mental health, alcohol and drug use than others. Nicotine dependence represents a larger health political challenge for the authorities than previously recognised.
Smoking in pregnancy is unequivocally harmful to both foetal and maternal health. Earlier investigations in Norway among pregnant women who smoke have demonstrated a prevalence of smoking of around 40% and that some women stop smoking as soon as the pregnancy is confirmed (around 20%). This investigation reports only 16% smokers among pregnant women registered at 18th week of pregnancy in the two municipalities of Asker and Baerum. Average daily consumption was 8.6 cigarettes, and 65% of the women stated that they smoked more than five cigarettes per day. 97% expressed a positive interest in quitting smoking, and 76% had tried to quit earlier. 77% had a partner who was a daily smoker. An assessment of level of education showed that 82% had completed 12 years of schooling and 23% reached a higher educational level. We conclude that the relatively low incidence of daily smoking among pregnant women in these two municipalities should inspire the initiation of active intervention programmes.
BACKGROUND: Establishing smoke-free hospitals by the end of 1995 was a goal for Norwegian health authorities. The present study reports the smoking status in Norwegian hospitals by the end of the year 2000. MATERIAL AND METHODS: Information was collected by questionnaires sent to all 81 Norwegian hospital directors; 78 (96%) responded. RESULTS: 19 hospitals (27%) were still not smoke-free. The lowest smoke-free rate (60%) was reported from psychiatric institutions. Smoking in all office areas was prohibited while 10% of all hospitals allowed smoking in their cafeterias. Outdoor smoking areas were provided in two thirds of the hospitals. Separate smoking rooms for patients were more common in non-smoke-free hospitals (79%) than in smoke-free institutions. The smoking restrictions were accepted with little resistance, but illicit smoking was not uncommon, even in-house. Sale of tobacco and cigarettes was a widespread practice in the hospitals (63%), irrespective of their smoking policy. INTERPRETATION: It appears that there is still a long way to go before Norwegian hospitals are really smoke-free. Sale of tobacco and cigarettes should be banned and further restrictive measures from the government are required together with active participation from doctors and nurses as role models and not the least from the patients themselves, in their own best interest.