Abstract：
OBJECTIVE: In Finland, nicotine pouches entered the national market abruptly in 2023, following a change in April 2023 from medicinal product classification into less regulated tobacco surrogate status. This study aimed to measure adolescent nicotine pouch use and associated characteristics.
METHODS: A cross-sectional, nationwide school-based survey among students in comprehensive schools (COMP), general upper secondary schools (GEN) and vocational institutes (VOC) in 2023 in Finland.
METHODS: A total of 151 224 respondents aged 14-20 years (mean age 16.18 years, standard deviation 1.20 years).
METHODS: Nicotine pouch use was used as the outcome variable. Demographics included age, sex, school type and tobacco product use (smoking, snus use and e-cigarette use). Covariates included parental education and parental smoking. All measures were self-reported.
RESULTS: Unadjusted results showed that current nicotine pouch use was more common among boys (11.3%) than among girls (3.3%), adolescents in VOC (15.4%) compared with COMP (6.8%) and GEN (4.3%), whereas daily use of other tobacco and nicotine products was associated with current nicotine pouch use compared with never using such products and the association was especially strong for snus use. The fully adjusted estimates of current nicotine pouch use remained strong for daily use of other tobacco and nicotine products (snus use: adjusted prevalence ratio [aPR] = 74.95, 95% confidence interval [CI] = 65.65-84.25; smoking: aPR = 1.43, 95% CI = 1.36-1.50; e-cigarette use: aPR = 2.15, 95% CI = 2.04-2.27) and for sex (boys aPR = 1.53, 95% CI = 1.48-1.57). There was no clear evidence of differences in current nicotine pouch use by school type, age or parental factors in the fully adjusted model.
CONCLUSIONS: In Finland in 2023, during which the availability of nicotine pouches became less regulated, nicotine pouch use appeared to be more common among boys and adolescents who used other nicotine products.
METHODS: A cross-sectional, nationwide school-based survey among students in comprehensive schools (COMP), general upper secondary schools (GEN) and vocational institutes (VOC) in 2023 in Finland.
METHODS: A total of 151 224 respondents aged 14-20 years (mean age 16.18 years, standard deviation 1.20 years).
METHODS: Nicotine pouch use was used as the outcome variable. Demographics included age, sex, school type and tobacco product use (smoking, snus use and e-cigarette use). Covariates included parental education and parental smoking. All measures were self-reported.
RESULTS: Unadjusted results showed that current nicotine pouch use was more common among boys (11.3%) than among girls (3.3%), adolescents in VOC (15.4%) compared with COMP (6.8%) and GEN (4.3%), whereas daily use of other tobacco and nicotine products was associated with current nicotine pouch use compared with never using such products and the association was especially strong for snus use. The fully adjusted estimates of current nicotine pouch use remained strong for daily use of other tobacco and nicotine products (snus use: adjusted prevalence ratio [aPR] = 74.95, 95% confidence interval [CI] = 65.65-84.25; smoking: aPR = 1.43, 95% CI = 1.36-1.50; e-cigarette use: aPR = 2.15, 95% CI = 2.04-2.27) and for sex (boys aPR = 1.53, 95% CI = 1.48-1.57). There was no clear evidence of differences in current nicotine pouch use by school type, age or parental factors in the fully adjusted model.
CONCLUSIONS: In Finland in 2023, during which the availability of nicotine pouches became less regulated, nicotine pouch use appeared to be more common among boys and adolescents who used other nicotine products.
摘要：
目标：在芬兰，在2023年4月从医药产品分类更改为监管较少的烟草替代状态之后，尼古丁袋在2023年突然进入全国市场。这项研究旨在测量青少年尼古丁袋的使用和相关特征。
方法：横截面，全国综合学校学生校本调查(COMP)，芬兰2023年的普通高中(GEN)和职业学院(VOC)。
方法：共有151224名14-20岁的受访者（平均年龄16.18岁，标准偏差1.20年)。
方法：使用尼古丁袋作为结果变量。人口统计包括年龄，性别,学校类型和烟草产品使用(吸烟，鼻烟使用和电子烟使用)。协变量包括父母教育和父母吸烟。所有措施都是自我报告的。
结果：未经调整的结果显示，目前尼古丁袋的使用在男孩中（11.3%）比在女孩中（3.3%）更为普遍，青少年VOC（15.4%）与COMP（6.8%）和GEN（4.3%）相比，而其他烟草和尼古丁产品的日常使用与目前使用尼古丁袋相比从未使用此类产品，这种关联在鼻烟使用中尤其强烈。对于其他烟草和尼古丁产品的日常使用，对当前尼古丁袋使用的完全调整后的估计仍然很高（鼻烟使用：调整后的流行率[aPR]=74.95，95％置信区间[CI]=65.65-84.25；吸烟：aPR=1.43，95％CI=1.36-1.50；电子烟使用：aPR=2.15，95％CI=2.27），性别（男孩=1.没有明确的证据表明，目前不同学校类型的尼古丁袋使用存在差异，完全调整模型中的年龄或父母因素。
结论：在2023年的芬兰，尼古丁袋的可用性变得不那么受管制，在使用其他尼古丁产品的男孩和青少年中，尼古丁袋的使用似乎更常见。
方法：横截面，全国综合学校学生校本调查(COMP)，芬兰2023年的普通高中(GEN)和职业学院(VOC)。
方法：共有151224名14-20岁的受访者（平均年龄16.18岁，标准偏差1.20年)。
方法：使用尼古丁袋作为结果变量。人口统计包括年龄，性别,学校类型和烟草产品使用(吸烟，鼻烟使用和电子烟使用)。协变量包括父母教育和父母吸烟。所有措施都是自我报告的。
结果：未经调整的结果显示，目前尼古丁袋的使用在男孩中（11.3%）比在女孩中（3.3%）更为普遍，青少年VOC（15.4%）与COMP（6.8%）和GEN（4.3%）相比，而其他烟草和尼古丁产品的日常使用与目前使用尼古丁袋相比从未使用此类产品，这种关联在鼻烟使用中尤其强烈。对于其他烟草和尼古丁产品的日常使用，对当前尼古丁袋使用的完全调整后的估计仍然很高（鼻烟使用：调整后的流行率[aPR]=74.95，95％置信区间[CI]=65.65-84.25；吸烟：aPR=1.43，95％CI=1.36-1.50；电子烟使用：aPR=2.15，95％CI=2.27），性别（男孩=1.没有明确的证据表明，目前不同学校类型的尼古丁袋使用存在差异，完全调整模型中的年龄或父母因素。
结论：在2023年的芬兰，尼古丁袋的可用性变得不那么受管制，在使用其他尼古丁产品的男孩和青少年中，尼古丁袋的使用似乎更常见。
