The social environment is most important for not using snus or smoking among adolescents

Aims: To identify factors, which were related to being smoke-free and snus-free, respectively, among adolescents in relation to adolescents who were smoking and/or using snus, and determine if there were any sex differences. Methods: A questionnaire study was performed among students in year two in upper secondary schools (17-years-old) in southern Sweden in 2009. More than 2200 students completed the questionnaire regarding health and living habits anonymously. The variables were tested by χ2-test, before selection into the logistic model. Because of the salutogenic approach in the study, the results of the logistic regression analyses were expressed as Positive Odds Ratio (POR). Results: The prevalence of being smokefree was 75.6 percent for girls and 70.2 percent for boys, whilst the prevalence of being snusfree was 95.1 percent for girls and 70.2 percent for boys. Having a tobacco-free best friend was the most important factor that correlated with being smokeand snus-free as an adolescent, for both boys and girls. Good living habits, such as drinking less alcohol, were also central to being smoke-free and snus-free. Conclusions: The results show that a tobacco-free environment has a great influence on whether or not adolescents stay tobacco-free. As the environment has a big impact, the school has a big challenge to work with the school environment and policies but also with family responsibility, norms and attitudes to tobacco.