Stopping when knowing: use of snus and nicotine during pregnancy in Scandinavia

Ina Kreyberg, Karen E S Bains, Kai-H Carlsen, Berit Granum, Hrefna K Gudmundsdóttir, Guttorm Haugen, Gunilla Hedlin, Katarina Hilde, Christine M Jonassen, Live S Nordhagen, Björn Nordlund, Katrine D Sjøborg, Håvard O Skjerven, Anne C Staff, Cilla Söderhäll, Riyas M Vettukatil, Karin C Lødrup Carlsen, Ina Kreyberg, Karen E S Bains, Kai-H Carlsen, Berit Granum, Hrefna K Gudmundsdóttir, Guttorm Haugen, Gunilla Hedlin, Katarina Hilde, Christine M Jonassen, Live S Nordhagen, Björn Nordlund, Katrine D Sjøborg, Håvard O Skjerven, Anne C Staff, Cilla Söderhäll, Riyas M Vettukatil, Karin C Lødrup Carlsen

Abstract

In young women, the use of snus increases in parallel with decreasing smoking rates but the use in pregnancy is unclear. Our aims were to determine the prevalence of snus use, smoking and other nicotine-containing product use during pregnancy, and to identify predictors for snus use in pregnancy. Prevalence was determined for 2528 women in Norway and Sweden based on the Preventing Atopic Dermatitis and ALLergies (PreventADALL) study, a population-based, mother-child birth cohort. Electronic questionnaires were completed in pregnancy week 18 and/or week 34, and potential predictors of snus use were analysed using logistic regression models. Ever use of any snus, tobacco or nicotine-containing products was reported by 35.7% of women, with similar rates of snus use (22.5%) and smoking (22.6%). Overall, 11.3% of women reported any use of nicotine-containing products in pregnancy up to 34 weeks, most often snus alone (6.5%). Most women (87.2%) stopped using snus by week 6 of pregnancy. Snus use in pregnancy was inversely associated with age and positively associated with urban living and personal or maternal history of smoking. While 11.3% of women used snus or other nicotine-containing products at some time, most stopped when recognising their pregnancy. Younger, urban living, previously smoking women were more likely to use snus in pregnancy.

Conflict of interest statement

Conflict of interest: B. Nordlund has nothing to disclose. Conflict of interest: K-H. Carlsen has received an honorarium for a lecture from Boehringer Ingelheim, outside the submitted work. Conflict of interest: A.C. Staff has nothing to disclose. Conflict of interest: C.M. Jonassen has nothing to disclose. Conflict of interest: L.S. Nordhagen has nothing to disclose. Conflict of interest: K.D. Sjøborg has nothing to disclose. Conflict of interest: G. Hedlin has nothing to disclose. Conflict of interest: H.K. Gudmundsdóttir has nothing to disclose. Conflict of interest: R.M. Vettukatil has nothing to disclose. Conflict of interest: C. Söderhäll has nothing to disclose. Conflict of interest: K. Hilde has nothing to disclose. Conflict of interest: H.O. Skjerven has nothing to disclose. Conflict of interest: K.E.S. Bains has nothing to disclose. Conflict of interest: B. Granum has nothing to disclose. Conflict of interest: G. Haugen has nothing to disclose. Conflict of interest: I. Kreyberg has nothing to disclose. Conflict of interest: K.C. Lødrup Carlsen reports grants as declared in the support statement. She has also received an honorarium for a lecture at the EAACI conference in 2018 from ThermoFisher Scientific, as well as a speaker honorarium from ThermoFisher Scientific outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Percentage of women using snus and/or cigarette smoke during pregnancy based on self-reported time for stopping from those who completed both 18-week and 34-week questionnaires (n=2187). Time for stopping categories were from 1–2 weeks to >16 weeks and from

FIGURE 2

Factors associated with snus use…

FIGURE 2

Factors associated with snus use during pregnancy. In multivariate analysis, the following factors…

FIGURE 2
Factors associated with snus use during pregnancy. In multivariate analysis, the following factors were identified as associated with the use of snus at some time during pregnancy (reference categories are presented in italic for each factor): living area (countryside (village) versus city (densely populated), city (less densely populated), suburb, countryside (outside village)); grand maternal cigarette smoking (no versus yes, do not know); country of origin (rest of the world and other nordic countries combined versus Norway or Sweden); previous and/or current smoking (no versus yes); marital status (married versus cohabitant, single, divorced/separated, other). Age was used as a continuous variable. OR: odds ratio. #: in utero smoking exposure of the index woman; *: p<0.05; **: p<0.01.
FIGURE 2
FIGURE 2
Factors associated with snus use during pregnancy. In multivariate analysis, the following factors were identified as associated with the use of snus at some time during pregnancy (reference categories are presented in italic for each factor): living area (countryside (village) versus city (densely populated), city (less densely populated), suburb, countryside (outside village)); grand maternal cigarette smoking (no versus yes, do not know); country of origin (rest of the world and other nordic countries combined versus Norway or Sweden); previous and/or current smoking (no versus yes); marital status (married versus cohabitant, single, divorced/separated, other). Age was used as a continuous variable. OR: odds ratio. #: in utero smoking exposure of the index woman; *: p<0.05; **: p<0.01.

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