Contrasting smokers’ and snus users’ perceptions of their personal tobacco behavior in Norway

In Norway, snus use and cigarette smoking are at different developmental stages as described by the diffusion of innovation model. Concomitant with declining smoking rates, the use of snus is increasing. In light of these differences in use trends, we assumed that snus users and cigarette smokers would have different perceptions of their personal tobacco use. A total of 4 852 smokers and snus users were recruited from a large sample of online panellists (n=62 000) and a postal database (n=15 000). The responses to 16 evaluative statements assessing perceptions about tobacco use were compared between exclusive snus users and exclusive smokers, and within dual users. The statements concerned self-evaluative emotions, moral judgements, social disapproval, and benefits of quitting. The perceptions of personal tobacco use differed greatly between exclusive smokers and exclusive snus users, even after controlling for age and sex. Smoker’s perceptions were more negative compared with snus users’ perception. The differences between smoking and snus use were particularly large for indices of social disapproval (Cohen’s d=1.56) and benefits from quitting use of the product (Cohen’s d=1.47) between exclusive users. Dual users exhibited a similar pattern. Smokers have more negative perception of own use compared to snus users. Dual users also devaluates smoking in comparison to their snus use. This finding may have important values for prevention strategies targeting smokers, snus users, and dual users

Evaluering av helseadvarslene på tobakkspakkene

På oppdrag fra Sosial- og helsedirektoratet har SIRUS evaluert endringen i helseadvarsler på sigarettpakkene som ble foretatt høsten 2003. Fra 2004 økte advarselsmerkingens areal til 30 % av pakkens forside og 40 % av pakkens bakside, samtidig med at flere nye tekster ble innført. Evalueringen viste at det var høy oppmerksomhet rundt tiltaket blant voksne røykere i alderen 16-74 år. 91 % av de spurte hadde lagt merke til en økning i advarselstekstens størrelse. På spørsmål om prosessering, var det 25 % som rapporterte at de leste advarselsteksten godt, mens 66 % sa de ikke hadde lest innholdet i særlig grad. Som reaksjon på advarselsmerkingen oppga 36 % at de aktiverte tanker om røykeslutt, mens 28 % erklærte seg enig i at advarslene hadde gjort dem mer bekymret for egen helse. 41 % trodde at andre røykere ikke hadde eller ville legge merke til de nye helseadvarslene. 23 % syntes advarslene opptok for stor plass på tobakkspakkene. En undersøkelse blant ungdom som røykte viste at 73 % betraktet merkingen som troverdig, og 30 % oppga at advarslene reduserte deres lyst på å røyke. Datamaterialet i denne rapporten er hentet fra Sosial- og helsedirektoratets årlige tobakksundersøkelse 4. kvartal 2003 og 2004, utført av Statistisk sentralbyrå. Det er også anvendt data fra en undersøkelse om røyking blant ungdom gjennomført av Opinion på oppdrag fra Sosial- og helsedirektoratet høsten 200

Hardcore Smokers in Norway 1996–2009

In Norway, the prevalence of daily smoking has gradually declined from 50% among men and 30% among women in the early 1970s to 13% in both genders in 2015. The rate of occasional smoking has remained stable at approximately 10% in recent decades. Presumably, this decline in the historically prevalent and socially rooted practice of smoking signals the final stage of the tobacco epidemic, which is characterized by an increasing social gradient within the steadily decreasing segment of smokers. Norway was once a pioneer in tobacco control and introduced a comprehensive governmental program to reduce smoking, including a total ban on tobacco advertising starting in the mid-1970s. Since then, most of the policy instruments recommended by the World Health Organization to combat smoking have been implemented. In addition to a robust infrastructure for tobacco control, there has also been a focus on social denormalization strategies to make cigarettes less desirable and less accessible, and the act of smoking less acceptable. However, given the severe harm associated with smoking, the tobacco control community considers the decline in smoking to be too slow. In particular, there has been a concern for a possible asymptotic plateau in smoking rates. Whether smoking rates will tend to flatten in countries that have reached the last phase of the tobacco epidemic has also been an issue for researchers. One approach has been to investigate the number of “hardcore smokers” to test the much-discussed “hardening hypothesis”. Hardcore smokers are inveterate smokers who do not want to or are not able to quit smoking and therefore are considered a difficult segment to reach by traditional tobacco control measures. The hardening hypothesis postulates that the proportion of hardcore smokers will increase as smoking prevalence declines. The overall aim of this thesis is to increase our understanding of those who continue to smoke, as the normative and socio-material climate tends to facilitate non-smoking. I use various survey data sets to address four main topics in this thesis. The first paper investigates the size of the hardcore smoker group and whether the relative size of the group has changed over time in the population of smokers. We concluded that the size of the hardcore group of smokers remains relatively moderate in Norway, and we found little support for the hardening hypothesis. However, this conclusion depends upon how hardcore smokers are operationalized. Increased knowledge about the mechanisms underlying smokers’ willingness and/or ability to quit is needed. The second paper examines differences between smokers and snus users and their perceptions of their own tobacco use, self-evaluative emotions, perceived moral judgment and social disapproval of their tobacco use. Compared with snus users, we observed that smokers tend to hold more negative emotions about and experience more social disapproval of their tobacco behaviour. Social inequality in smoking behaviour is addressed in the third paper. More precisely, I set out to explore the associations between education, income and the risk of smoking. I conclude that low education is associated with a greater risk of dependence, heavy smoking and having no intention to quit. The last paper in this thesis explored public opinions for 16 novel tobacco control strategies. Smokers opposed all of the proposed strategies except banning smoking in cars carrying children, increasing the age limit for purchasing cigarettes, and banning smoking at transportation stops. The legitimacy of the newly proposed tobacco control measures is discussed within a justification framework. Overall, I conclude that many smokers experience a subjective feeling of stigmatization, they express resistance to increased tobacco control measures and there are some signs of social marginalization processes. In the thesis, these results are discussed in a social inequality and social resistance framework. In addition, smoking is discussed in relation to social stigma and neutralization of risk. The mechanisms underlying the inequality, stigmatization and resistance associated with smoking behaviour need further investigation

Norwegian Tobacco Statistics 1973-2006

This publication describes tobacco use trends in Norway from the first surveys in 1973 and up to today. Smoking, the use of snus, exposure to passive smoking and smoking cessations is addressed. The first chapter shows the prevalence of daily and occasional smoking. The second chapter gives an overview of the prevalence of snus use. Chapter 3 covers self-reported consumption and changes in registered tobacco sales in Norway in recent years. Smoking cessation is the focus of Chapter 4, which discusses successful attempts to quit, quit attempts among daily smokers, and the intention to quit smoking. Chapter 5 deals with passive smoking, with emphasis on the change in attitude seen since the early 1990s. The final chapter addresses the topic of smoking and social inequality, measured by educational level

Gastrointestinal symptoms of infantile colic and their change after light needling of acupuncture: a case series study of 913 infants

<p>Abstract</p> <p>Background</p> <p>Infantile colic is a common painful clinical condition associated with signs of distended intestines and an increase in colon peristalsis. However, clinical documentation of observed gastrointestinal functions in the condition is still lacking. Even though the ailment is common, no clear treatment guidelines exist. While acupuncture with minimal stimulation has been shown to be effective in reducing crying behaviour of infants suffering from colic, the documented effect of acupuncture on gastrointestinal function in children with infantile colic is scarce. This case series study aims to document the symptoms of routinely rated gastrointestinal function and the changes in these symptoms after minimal acupuncture in a larger group of children with infantile colic.</p> <p>Methods</p> <p>This study included 913 infants with normal weights, and lengths at birth. The infants' mean age was 5.4 weeks when the observations started, and had colic symptoms since two weeks after birth. Light needling stimulation of the acupuncture point LI4 was performed for 10-20 seconds bilaterally on a daily basis for a mean of 6.2 consecutive days. A questionnaire with verbal rating scales for the parents' evaluation was used before and after the treatment period.</p> <p>Results</p> <p>Before treatment the infants were assessed by the parents in terms of 'often have inflated stomachs' (99%) and 'seldom drool' (76%), 'regurgitate' (53%) and 'belch' (62%). Moreover, the reported frequency of defecation was 5-8 times per day (64%), with a yellowish-green colour (61%) and with a water-thin consistency (74%). After treatment, the variables of inflated stomachs, drooling and regurgitating were systematically changed, and rated by the parents as occurring 'sometimes' while belching was rated as occurring 'often' and the frequency of defecation was reduced to 1-4 times/day with a mustard yellow colour and a gruel-like consistency. The parents also rated their impression of the infants' general colic symptoms including crying behaviour as much ameliorated in 76% of the cases.</p> <p>Conclusion</p> <p>The results of the present study show that minimal acupuncture at LI4 in infantile colic is an effective and easy treatment procedure that, furthermore, is reported to be without serious side effects.</p

A longitudinal study of Campylobacter distribution in a turkey

Background: Campylobacter is the most common cause of bacterial enteritis worldwide. Handling and eating of contaminated poultry meat has considered as one of the risk factors for human campylobacteriosis.Campylobacter contamination can occur at all stages of a poultry production cycle. The objective of this study was to determine the occurrence of Campylobacter during a complete turkey production cycle which lasts for 1,5 years of time. For detection of Campylobacter, a conventional culture method was compared with a PCR method. Campylobacter isolates from different types of samples have been identified to the species level by a multiplex PCR assay. Methods: Samples (N = 456) were regularly collected from one turkey parent flock, the hatchery, six different commercial turkey farms and from 11 different stages at the slaughterhouse. For the detection of Campylobacter, a conventional culture and a PCR method were used. Campylobacter isolates (n = 143) were identified to species level by a multiplex PCR assay. Results: No Campylobacter were detected in either the samples from the turkey parent flock or from hatchery samples using the culture method. PCR detected Campylobacter DNA in five faecal samples and one fluff and eggshell sample. Six flocks out of 12 commercial turkey flocks where found negative at the farm level but only two were negative at the slaughterhouse. Conclusion: During the brooding period Campylobacter might have contact with the birds without spreading of the contamination within the flock. Contamination of working surfaces and equipment during slaughter of a Campylobacter positive turkey flock can persist and lead to possible contamination of negative flocks even after the end of the day's cleaning and desinfection. Reduction of contamination at farm by a high level of biosecurity control and hygiene may be one of the most efficient ways to reduce the amount of contaminated poultry meat in Finland. Due to the low numbers of Campylobacter in the Finnish turkey production chain, enrichment PCR seems to be the optimal detection method here