A new generation of nicotine addicts

The tobacco and nicotine use among Swedish youth has been increasing drastically in recent years. Around 20 percent of high school students smoke. The use of the oral tobacco product snuff and novel nicotine products, such as e-cigarettes and nicotine pouches, is higher than ever. According to a new national school survey, 40 percent of high school students have tried nicotine pouches and 48 percent have tried e-cigarettes.

Why do young people start using tobacco?

Consistently since the first survey on attitudes towards tobacco was conducted in 2016, the most prominent reported reason for starting to use tobacco is the influence of friends. Between 80 and 90 percent of youths aged 14-18 agree with this. Other significant reported reasons are mental illness, lack of support from adults, and tobacco use among role models.

The influence of friends is also topping the list of reasons to try novel nicotine products. Other significant reasons, which specifically apply for these newer products, are a perception that these products appear less harmful than traditional tobacco products, appealing flavors, and the occurrence of these products in popular culture (TV, music, social media). 26 percent of youths say they are often exposed to marketing or ads promoting tobacco and nicotine products.

These results mean that young people rarely start to use tobacco or nicotine voluntarily. Most often it is rather a matter of peer pressure in social contexts or the influence of other external factors, such as role models and the marketing strategies of the tobacco industry.

Misconceptions of youth´s everyday life

A reoccurring tendency in this survey is the fact that adults seem to have limited insight into many aspects of young people´s lives. This is especially clear when it comes to the availability and usage of tobacco among minors. A significantly larger share of youth aged 14-18 agrees that smoking is common among minors, and that it is easy to get access to e-cigarettes, compared to the adult public.

It appears as if adults also underestimate their own influence in this matter. Youths, more often than adults, answer that the lack of support from adults can be a reason to start using tobacco. Similarly, when asked about sufficient reasons to abstain from using tobacco, the younger target group answers “the approach/demands of parents” to a higher extent.

Knowledge gaps

Another persistent trend in this survey is the widespread ignorance regarding various tobacco-related harms, such as the severe health effects of nicotine. Around ten percent of adults are aware that nicotine increases risk of mental illness and learning disabilities. The corresponding numbers among youth are somewhat higher, but the vast majority lacks this knowledge.

The public awareness of the tobacco industry´s impact on human rights and the environment is equally low. Hardly one third of adults know that child labor is frequently exploited in tobacco farming, and only eleven percent are aware that the tobacco industry causes massive deforestation. The young target group is better informed of the sustainability problems caused by the tobacco industry, but there are big knowledge gaps to be filled in all age groups. This is especially relevant since many youths care about these global issues and would be motivated to abstain from using tobacco as a way to take action for a more sustainable future.

Due to the increasing popularity of novel nicotine products marketed as tobacco-free, the survey includes a question regarding the origin of the nicotine. Only five percent of adults, and eight percent of youths, are aware that the nicotine in e-cigarettes and nicotine pouches is extracted from tobacco plants. This marketing strategy by the tobacco industry – along with appealing flavors, attractive packaging, and misleading claims about health effects – has clearly created a widespread perception that these products are exempted from all harms of traditional tobacco.

Extensive public support for tobacco prevention

Over the years of the survey, the public opinion has been in favor of many different measures intended to prevent and reduce tobacco use. The 2022 survey shows increasing support for smoke-free outdoor areas of restaurants and bars since it entered into force in 2019. A big majority is positive towards raising tobacco taxes, enforcing a ban on tobacco sales for future generations (as already done in New Zealand), and implementing tobacco-free school hours. Sweden is the last remaining country in Scandinavia that has not yet banned all tobacco or nicotine products, other than pharmaceutical, during school hours. The support for these measures is especially high among young people.

An overwhelming majority is also in opposition of collaborations, by for example social media influencers and marketing agencies, with tobacco companies.

Summary

The results of this survey provide insight into the aspects and conditions of youth´s everyday lives that influence their risk of initiating a nicotine addiction. They also highlight the importance of strengthening tobacco control efforts and raising public awareness of all tobacco-related harms, especially due to the rapidly increasing tobacco and nicotine use among minors. If policy makers and authorities allocate more attention and resources for tobacco prevention, they would provide more children with the protection they need to stay tobacco-free, while simultaneously enhancing public health, the environment, and contributing to secure a sustainable development globally. A Non Smoking Generation calls for action, and proposes these six measures:

1. Enforce a law regulating tobacco-free school hours
2. Enforce mandatory education about tobacco-related health and sustainability issues in schools
3. Conduct information campaigns about new tobacco and nicotine regulation
4. Apply a zero tolerance policy towards marketing and flavorings
5. Raise tobacco taxes and enforce a sustainability tax on tobacco products
6. Raise the age limit for tobacco purchases from 18 to 20

The article is written by Helen Stjerna, Secretary-General A Non Smoking Generation, on request of PopNAD