• K Slama, S David-Tchouda, and J-M Plassart.
• Unité de Coordination de Tabacologie, CHU de Grenoble, 38043 Grenoble Cedex 09, France. katia.slama@hotmail.fr
• Rev Epidemiol Sante. 2009 Aug 1; 57 (4): 299-304.

BackgroundAs a result of tobacco control measures in France, smoking among adolescents is decreasing. However, this decrease is associated with changes in the way youth are consuming tobacco and turning towards new tobacco products: cheaper forms of tobacco such as rolling or chewing tobacco, or fashionable forms such as narghile. The aim of this study is to describe in young adults: (1) prevalence of tobacco use and main risk factors of daily smoking, (2) the entry mode for tobacco use and (3) prevalence and main risk factors related to "chewing tobacco" used as snuff.MethodsA descriptive transversal study was undertaken in five private and public high schools in the French Alps region in 2008. Anonymous questionnaires were given out to the students of 12th grade (last year of general secondary education) and BTS (professional training). Smoking prevalence and other forms of tobacco consumption were described, as well as the entry mode in tobacco use. Finally, we used logistic models to identify the main determinants of smoking cigarettes and using chewing tobacco.ResultsThis study included 920 students: 22.3% (95% IC: 19.6-25.0) were daily smokers and 65.9% (95% IC: 62.8-69.0) had tried tobacco. Approximately 40% had experimented with rolling tobacco, cannabis or narghile. We found the usual determinants of daily smoking: an environment conducive to smoking, and not belonging to a sports club. Around 11% (95% IC: 9.2-13.2) had tried chewing tobacco. Risk factors associated with chewing tobacco were: having a smoking friend (adjusted OR: 3.07; 95% IC: 1.95-4.83), studying in a private school (adjusted OR: 2.57; 95% IC: 1.52-4.31), or being male (adjusted OR: 1.79; 95% IC: 1.15-2.79).ConclusionAs found in national studies, cigarette smoking is declining among young adults, but the use of other tobacco products (narghile, chewing tobacco) is emerging. The relatively high consumption rate and the risk factors of chewing tobacco need to be examined in depth in order to organize prevention programs for young adults.

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