Objectives:: There is limited research on combined use of cigarettes, snus and e-cigarettes in the Nordic countries. This study will investigate whether this pattern of use occurs among adolescents in Norway. In addition, we will investigate the association between combined use of several tobacco products, e-cigarettes and socio-demographic and psychosocial factors (SPF).
Method:: A school-based cross-sectional survey of adolescents in the 8th to the 12th grade (N = 875) in 2014. Information on the use of cigarettes, snus, e-cigarettes and SPF was collected using an electronic questionnaire.
Results:: Of the adolescents, 31% reported having tried or used one or more tobacco product and/or e-cigarette. Of these, over half reported having tried or used one product, 1/3 two products and 1/10 three products. There were more boys among poly-users (63%) than among single-users (44%). Compared to single-users, poly-users also reported weaker school performance (30% and 11%, respectively), more often reported drinking alcohol to intoxication (91% and 75%, respectively), and having tried cannabis (28% and 9%, respectively). Poly-users also scored higher on impulsivity, sensation-seeking and depression.
Conclusion:: The study shows that combined use of tobacco products and e-cigarettes occurs among young people in Norway. Such use was associated with psychosocial and socio-demographic risk factors. There is a need to investigate this phenomenon in more details in representative samples.