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Snus use and other correlates of smoking cessation in the Swedish Twin Registry

Published online by Cambridge University Press:  10 December 2007

H. Furberg ,
P. Lichtenstein ,
N. L. Pedersen ,
C. M. Bulik ,
C. Lerman  and
P. F. Sullivan
H. Furberg*
Affiliation:
Department of Genetics, University of North Carolina at Chapel Hill, NC, USA
P. Lichtenstein
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
N. L. Pedersen
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Psychology, University of Southern California, CA, USA
C. M. Bulik
Affiliation:
Department of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, NC, USA
C. Lerman
Affiliation:
Department of Psychiatry, Transdisciplinary Tobacco Use Research Center, University of Pennsylvania, PA, USA
P. F. Sullivan
Affiliation:
Department of Genetics, University of North Carolina at Chapel Hill, NC, USA Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
*
*Address for correspondence: Dr H. Furberg, Department of Genetics, CB#7264, 4109D Neurosciences Research Building, University of North Carolina, Chapel Hill, NC 27599-7264, USA. (Email: [email protected])
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Abstract

Background

We investigated 12 variables and their interactions as correlates of smoking cessation among regular smokers in the population-based Swedish Twin Registry (STR).

Method

Detailed information on tobacco use and personal characteristics were available from 14 715 male and female twins aged 42–64 years who participated in a screening of the population-based STR and reported being regular smokers in their lifetime. A two-stage analytic design was used to examine correlates of smoking cessation. The sample was split at random and significant main effects and interactions identified in the testing set were examined in the validation set. Hazard ratios (HRs) and 95% confidence intervals (CIs) describe the association between correlates and smoking cessation.

Results

Twelve main effects were significantly associated with smoking cessation in the testing set; eight were confirmed in the validation set. Of the nine interactions identified in the testing set, none remained significant when evaluated in the validation set after Bonferroni correction. HRs were highest for Swedish oral smokeless tobacco (snus) use (HR 2.70, 95% CI 2.30–3.20), >11 years of education (HR 1.57, 95% CI 1.43–1.73) and being married or cohabitating (HR 1.51, 95% CI 1.39–1.63). Although not statistically significant after Bonferroni correction, snus use also appeared important in the context of interactions, where lower nicotine dependence score, higher socio-economic status (SES) and greater body size were associated with smoking cessation only among participants who never used snus.

Conclusions

Snus use was the strongest independent correlate of smoking cessation. Further studies should investigate the mechanism of this association.

Keywords

CessationcorrelatessmokingsnusSweden
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 9 , September 2008 , pp. 1299 - 1308
Copyright
Copyright © 2007 Cambridge University Press

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