Advanced

Towards a tobacco-free generation. A study on the tobacco habits of adolescents: when, why and who?

Edvardsson, Ingrid LU (2012) In Lund University Faculty of Medicine Doctoral Dissertation Series 2012:78.
Abstract (Swedish)
Popular Abstract in Swedish

Sammanfattning

Varför ungdomar använder tobak är en stor och komplex fråga. Det finns faktorer på samhälls-, grupp- och individnivå som påverkar unga. Omgiv-ningens normer och attityder liksom föräldrars och kompisars tobaksvanor har betydelse och påverkar ungdomar att börja använda tobak eller att avstå. För att motverka tobaksbruk krävs en kombination av åtgärder på olika nivåer. Bland annat vet man att olika politiska åtgärder har effekt så-som prisökningar och lagstiftning där åldersgränsen efterlevs för inköp av tobak samt fler rökfria miljöer. Att erbjuda tobaksavvänjning till vuxna tobaksbrukare, och därmed minska antalet tobaksanvändare, är även en satsning som ger effekt för... (More)
Popular Abstract in Swedish

Sammanfattning

Varför ungdomar använder tobak är en stor och komplex fråga. Det finns faktorer på samhälls-, grupp- och individnivå som påverkar unga. Omgiv-ningens normer och attityder liksom föräldrars och kompisars tobaksvanor har betydelse och påverkar ungdomar att börja använda tobak eller att avstå. För att motverka tobaksbruk krävs en kombination av åtgärder på olika nivåer. Bland annat vet man att olika politiska åtgärder har effekt så-som prisökningar och lagstiftning där åldersgränsen efterlevs för inköp av tobak samt fler rökfria miljöer. Att erbjuda tobaksavvänjning till vuxna tobaksbrukare, och därmed minska antalet tobaksanvändare, är även en satsning som ger effekt för att ungdomar inte ska börja röka eller snusa.

Det övergripande syftet med avhandlingsarbetet var att öka kunskapen om ungdomars tobaksvanor och att undersöka vilka faktorer som kan vara användbara för hälsofrämjande arbete för tobaksfrihet bland ungdomar. Avhandlingen består av fyra delarbeten, tre kvantitativa och en kvalitativ studie. Samtliga studier är genomförda bland ungdomar i Kronobergs län i södra Sverige.

De två första studierna utgår från en datainsamling med upprepade årliga enkätundersökningar i tre respektive sju år. I den första studien gjordes ett försök att utvärdera en enklare intervention av A Non Smoking Generations klassbesök till elever i årskurs 6. Vid baslinjemätning i årskurs 6 fanns inte någon signifikant skillnad i rökvanor mellan interventionsgruppen och jäm-förelsegruppen. Två år efter interventionen genomfördes en ny enkätunder-sökning. När analysen utgick från vad eleven angett i enkäten huruvida de haft besök av inspiratör eller inte fanns en signifikant skillnad avseende rökvanor till interventionsgruppens fördel. Men då analysen genomfördes med en jämförelse mellan de skolor som eleven angett att de gått på, och om dessa skolor haft besök eller inte, kunde inte en signifikant skillnad ses.

I arbete två följdes en årskurs elever i en öppen kohort avseende tobaks-vaneutveckling och eventuella skillnader mellan könen. Resultatet visade att mellan årskurs 7 (13 år) och gymnasiets årskurs 1 (16 år) skedde den största ökningen för tobaksbruk för att stabiliseras under de två sista åren på gymnasiet. Snus introducerades senare än rökning i tonåringarnas liv. Flickor rökte mer än pojkar och pojkar snusade betydligt mer än flickor. Från och med årskurs 8 (14 år) låg pojkarna på en högre nivå än flickorna sett till den totala tobakskonsumtionen.

I det tredje arbetet som var kvalitativt, intervjuades gymnasieungdomar om sitt snusbruk. Snuset spelade en viktig roll för ungdomarnas identitet och grupptillhörighet. Framför allt var det viktigt för pojkarna som kände sig manliga då de snusade. Ungdomarna var inte medvetna om att de utveckla-de ett beroende och kände inte igen abstinenssymtomen i ett tidigt skede. Plötsligt stod de inför fakta att de blivit beroende och då var det svårt att sluta.

I sista arbetet studerades faktorer som var associerade med rök- respektive snusfrihet med en enkätundersökning till elever i gymnasiets årskurs 2. Omgivningens tobaksfrihet påverkade ungdomarna att förbli tobaksfria. Flickor föreföll vara mer påverkbara av en rökfri omgivning än pojkar. Pojkar påverkades av manliga (pappa och bror) snusfria förebilder medan flickor påverkades av att mamma och syster var snusfria.

Dagens folkhälsoarbete behöver omfatta både preventiva och hälsofräm-jande insatser. Interventioner på lokal nivå med till exempel NSG har betydelse på individnivå för att välja ett tobaksfritt liv. En utveckling av ett hälsofrämjande arbete med till exempel hälsofrämjande skola, en stödjande tobaksfri miljö, är en god investering för våra ungdomars hälsa. Här finns möjligheten att införa en tobaksfri skoltid, det vill säga att ingen använder någon form av tobak under skoltid, då visar vuxenvärlden att normen ska vara tobaksfritt. (Less)
Abstract
Why adolescents are using tobacco is a large and complex issue. There are factors on society, group and individual levels that affect the youngsters. The norms and attitudes in their surrounding, as well as the tobacco habits of parents and friends, are important when it comes to affecting adolescents to start using tobacco or abstain from it. Counteracting the use of tobacco requires a combination of actions at different levels. Among other things, it is known that it is effective to use various political actions, such as price increases and legislation whereby the age limit for purchase of tobacco is obeyed and more smoke-free environments are created. Offering adult tobacco users tobacco cessation, and thereby reducing the number of... (More)
Why adolescents are using tobacco is a large and complex issue. There are factors on society, group and individual levels that affect the youngsters. The norms and attitudes in their surrounding, as well as the tobacco habits of parents and friends, are important when it comes to affecting adolescents to start using tobacco or abstain from it. Counteracting the use of tobacco requires a combination of actions at different levels. Among other things, it is known that it is effective to use various political actions, such as price increases and legislation whereby the age limit for purchase of tobacco is obeyed and more smoke-free environments are created. Offering adult tobacco users tobacco cessation, and thereby reducing the number of tobacco users, is also an investment that has an effect to make fewer adolescents start smoking or using snus.

The overall aim of this dissertation work was to increase the knowledge on adolescent tobacco habits and explore the factors that may be used for health promotion work among adolescents to make them tobacco-free. The thesis consists of four parts, three quantitative studies and one qualitative study. All the studies were carried out among adolescents in the Kronoberg County in southern Sweden.

The first two studies were based on data collection with repeated annual surveys for three and seven years, respectively. The first study made an attempt to evaluate a more simple intervention by A Non Smoking Genera-tion through class visits to pupils in grade 6. A baseline measurement in grade 6 found no significant difference in smoking habits between the inter-vention group and the comparison group. Two years after the intervention, a new survey was conducted. When the analysis was based on pupil responses from the survey about whether they had been visited by an inspiring person or not, a significant difference in smoking habits was found in favour of the intervention group. But when the analysis was done as a comparison between schools that the pupil said he/she had attended, and whether these schools had been visited or not, no significant difference was found.

In the second study, a grade of pupils in an open cohort was followed with regard to development of smoking habits and any possible sex differences. The results showed that the largest increase in tobacco use was found between grade 7 (age 13) and upper secondary grade 1 (age 16), but it subsided during the last two upper secondary years. Snus were introduced later than smoking in the adolescents' lives. Girls smoked more than boys, and boys used far more snus than the girls did. From grade 8 (age 14), the boys were at a higher level than the girls, with regard to total tobacco consumption.

In the third study, which was qualitative, adolescents in upper secondary school were interviewed about their use of snus. The snus had an important role in the adolescents' identity and group affiliation. Primarily, it was important to boys, who felt manly when they used snus. The adolescents were not aware that they developed an addiction and did not recognize abstinence symptoms that appeared at an early stage. Suddenly, they had to face the fact that they had become addicted, and then it was difficult to quit.

In the final study, factors associated with being smoke- and/or snus-free were studied using a survey to pupils in grade 2 of upper secondary school. Surrounding people being tobacco-free affected the adolescents to remain tobacco-free. Girls appeared to be more prone than boys to be affected by a smoke free surrounding. Boys were affected by male (father and brother) snus-free role models, while girls were affected by a mother and sister being snus-free.

Today's public health work needs to cover both preventive and health promotion efforts. Interventions at a local level, for example with NSG, are important at an individual level for choosing a tobacco-free life. Develop-ment of health promotion work with for example a health promoting- school, a supportive tobacco-free environment, is a good investment for the health of our adolescents. Here, we have the possibility to introduce tobacco-free school hours, i.e. that nobody is using any form of tobacco during school hours. Then, the adult world really demonstrates that the norm is to be tobacco-free. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Prof. Jansson, Staffan, Karlstad Universitet
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Adolescents, smoking, snus use, health promotion, prevention, tobacco-free
in
Lund University Faculty of Medicine Doctoral Dissertation Series
volume
2012:78
pages
135 pages
publisher
Avd för kliniska vetenskaper, Malmö
defense location
CRC:s Aula Jan Waldenströms gata 35, Malmö
defense date
2012-10-03 09:15
ISSN
1652-8220
ISBN
978-91-87189-41-8
language
English
LU publication?
yes
id
7042e0b9-a9ad-496f-a363-dd8c67b819cc (old id 3050743)
date added to LUP
2012-09-17 11:00:27
date last changed
2016-09-19 08:44:47
@phdthesis{7042e0b9-a9ad-496f-a363-dd8c67b819cc,
  abstract     = {Why adolescents are using tobacco is a large and complex issue. There are factors on society, group and individual levels that affect the youngsters. The norms and attitudes in their surrounding, as well as the tobacco habits of parents and friends, are important when it comes to affecting adolescents to start using tobacco or abstain from it. Counteracting the use of tobacco requires a combination of actions at different levels. Among other things, it is known that it is effective to use various political actions, such as price increases and legislation whereby the age limit for purchase of tobacco is obeyed and more smoke-free environments are created. Offering adult tobacco users tobacco cessation, and thereby reducing the number of tobacco users, is also an investment that has an effect to make fewer adolescents start smoking or using snus. <br/><br>
The overall aim of this dissertation work was to increase the knowledge on adolescent tobacco habits and explore the factors that may be used for health promotion work among adolescents to make them tobacco-free. The thesis consists of four parts, three quantitative studies and one qualitative study. All the studies were carried out among adolescents in the Kronoberg County in southern Sweden. <br/><br>
The first two studies were based on data collection with repeated annual surveys for three and seven years, respectively. The first study made an attempt to evaluate a more simple intervention by A Non Smoking Genera-tion through class visits to pupils in grade 6. A baseline measurement in grade 6 found no significant difference in smoking habits between the inter-vention group and the comparison group. Two years after the intervention, a new survey was conducted. When the analysis was based on pupil responses from the survey about whether they had been visited by an inspiring person or not, a significant difference in smoking habits was found in favour of the intervention group. But when the analysis was done as a comparison between schools that the pupil said he/she had attended, and whether these schools had been visited or not, no significant difference was found.<br/><br>
In the second study, a grade of pupils in an open cohort was followed with regard to development of smoking habits and any possible sex differences. The results showed that the largest increase in tobacco use was found between grade 7 (age 13) and upper secondary grade 1 (age 16), but it subsided during the last two upper secondary years. Snus were introduced later than smoking in the adolescents' lives. Girls smoked more than boys, and boys used far more snus than the girls did. From grade 8 (age 14), the boys were at a higher level than the girls, with regard to total tobacco consumption. <br/><br>
In the third study, which was qualitative, adolescents in upper secondary school were interviewed about their use of snus. The snus had an important role in the adolescents' identity and group affiliation. Primarily, it was important to boys, who felt manly when they used snus. The adolescents were not aware that they developed an addiction and did not recognize abstinence symptoms that appeared at an early stage. Suddenly, they had to face the fact that they had become addicted, and then it was difficult to quit. <br/><br>
In the final study, factors associated with being smoke- and/or snus-free were studied using a survey to pupils in grade 2 of upper secondary school. Surrounding people being tobacco-free affected the adolescents to remain tobacco-free. Girls appeared to be more prone than boys to be affected by a smoke free surrounding. Boys were affected by male (father and brother) snus-free role models, while girls were affected by a mother and sister being snus-free.<br/><br>
Today's public health work needs to cover both preventive and health promotion efforts. Interventions at a local level, for example with NSG, are important at an individual level for choosing a tobacco-free life. Develop-ment of health promotion work with for example a health promoting- school, a supportive tobacco-free environment, is a good investment for the health of our adolescents. Here, we have the possibility to introduce tobacco-free school hours, i.e. that nobody is using any form of tobacco during school hours. Then, the adult world really demonstrates that the norm is to be tobacco-free.},
  author       = {Edvardsson, Ingrid},
  isbn         = {978-91-87189-41-8},
  issn         = {1652-8220},
  keyword      = {Adolescents,smoking,snus use,health promotion,prevention,tobacco-free},
  language     = {eng},
  pages        = {135},
  publisher    = {Avd för kliniska vetenskaper, Malmö},
  school       = {Lund University},
  series       = {Lund University Faculty of Medicine Doctoral Dissertation Series},
  title        = {Towards a tobacco-free generation. A study on the tobacco habits of adolescents: when, why and who?},
  volume       = {2012:78},
  year         = {2012},
}