Notably, we found a high prevalence of regular snus use regardles

Notably, we found a high prevalence of regular snus use regardless of initial reactions, especially among men. Our findings also highlight age at first snus use as a relevant predictor of future snus use among women, who selleck chemicals had a higher predicted probability of being snus users if they experimented with snus as adults. Dizziness and pleasurable buzz were the strongest predictors of smoking in this study, consistent with prior reports. Haberstick et al. (2011) examined retrospective responses to the ESE among 2,482 young adult twins and found that individual differences in initial reactions to cigarettes are best explained by heritable and environmental influences on dizziness. The authors suggest that dizziness may represent the most genetically informative subjective experience and therefore could be used clinically to identify individuals at risk of regular use (Haberstick et al.

, 2011). In a study comparing retrospective responses to the ESE with prospective responses to a Nicotine Spray Effects questionnaire among 58 young adult non-smokers with modest lifetime exposure to cigarettes, Perkins, Lerman, Coddington, and Karelitz (2008) found that reporting dizziness on the ESE was associated with greater prospective ratings of ��feel the effects�� and ��want more�� when comparing nicotine spray to placebo. This may indicate that the ESE item of dizziness predicts greater sensitivity to the reinforcing effects of nicotine (Perkins et al., 2008). Furthermore, the results of a factor analysis of reactions to initial cigarette use identified a ��pleasant�� dimension, an ��unpleasant�� dimension, and a ��buzz�� dimension that consisted of dizziness and pleasurable buzz.

The ��buzz�� factor was significantly associated with increased odds of progressing to regular smoking, and this effect was especially strong among individuals who did not experience any pleasant reactions (Richardson et al., 2010). Finally, among 8,373 youths who ever smoked a whole cigarette, Hu, Davies, and Kandel (2006) found that dizziness was significantly associated with 18% increased odds of ever daily smoking after adjustment for important potential confounders such as depressive symptoms, self-esteem, and having friends who smoke. To our knowledge, this is the first study to describe initial reactions to snus and their impact on future regular snus use.

Our finding that 79% of men and 54% of women who exclusively tried snus became Carfilzomib users is striking and suggests that, particularly for men, snus use is easily adopted after trying regardless of initial reactions. The tolerability of snus may be greater than cigarettes due to route of administration as nicotine is absorbed through the digestive system rather than inhaling, or to social acceptability as there is no secondhand smoke or public restrictions on its use. For women, it was notable that a later age at first snus use predicted future use.

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