Predictors of Early and Late Escalation of Smokeless Tobacco Use and Cigarette Smoking Among Swedish Adolescents

Knowledge concerning developmental trajectories of tobacco use has until recently been limited to smoking. We utilized information on 960 adolescents who participated in the BROMS cohort study, with follow-up between the ages of 11 and 18 years. Factors related to personal monetary allowance, psychosocial factors and alcohol drinking were used to predict individual probability of progression of snus (the Swedish smokeless tobacco) and of cigarettes. Predictors of snus use and smoking showed more similarities than differences. Friends' and parents' tobacco use did only discriminate between early and late progression in cigarette smoking (OR = 3.2, CI = 1.2 - 8.7 for friends' tobacco use and OR = 1.5, CI = 1.0 - 2.1 for parents' tobacco use). Weekly alcohol drinking was the strongest predictor of early progression to use tobacco (OR = 2.6, CI = 1.1 - 6.2 for snus use and OR = 6.3, CI = 2.4 - 16.8 for cigarette smoking). This knowledge can be used as a base for dedicated prevention strategies targeting different groups of young users.