BACKGROUND: Smoking has decreased among Finnish adolescents while the use of other tobacco and nicotine products has increased, with some gender differences. Little is known about the changes in use of e-cigarettes and snus (Swedish type smokeless tobacco) among adolescents who have never smoked cigarettes (NS) over time. We aimed to fill this knowledge gap.
METHODS: European School Survey Project on Alcohol and other Drugs (ESPAD) on two representative cross-sections of 15- to 16-year-old students between 2015 and 2024 in Finland was utilised. The participation rates of schools ranged from 93.8 % (n=4049 students) in 2015 to 82.7% (n=3294 students) in 2024. The dependent variables were lifetime use of e-cigarettes and lifetime use of snus, while the primary independent variable was time (survey year). Frequencies and adjusted logistic regression analyses were used. Adjusted odds ratios are reported, taking into account grade point average and parental monitoring which have been shown to be associated with the onset of tobacco use.
RESULTS: Lifetime use of e-cigarettes decreased among NS boys from 21% in 2015 to 14% in 2024 (corresponding adjusted odds ratios aOR=0.62; 95% CI 0.49–0.79), among NS girls it increased from 5% to 18% during the same period (aOR=4.08; 95% CI 2.98–5.57). Lifetime use of snus among NS boys decreased from 14% in 2015 to 5% in 2024 (aOR=0.29, 95% CI 0.19–0.41) while among girls it increased statistically non-significantly from 1% to 2% (aOR=1.12, 95% CI 0.55–2.29).
CONCLUSIONS: The use of e-cigarettes among girls who have never smoked has increased while both e-cigarette use and snus use have decreased among boys who have never smoked. Tobacco control policy measures should be enacted in Finland to prevent the use of any tobacco and nicotine product, such as raising the age limit of selling these products to 20 years.