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This study explores associations between use of tobacco and bone accretion in Norwegian adolescents. Our results indicate that use of snuff is negatively associated with accretion of aBMD in adolescence and may be a signal of increased future fracture risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Bone mineral accrual in childhood and adolescence is a long-term primary preventive strategy of osteoporosis. Areal bone mineral density (aBMD) is a surrogate measure of bone strength and a predictor of fracture risk. The aim of this population-based 2-year follow-up cohort study was to explore associations between use of snuff and smoking and changes (\u2206) in aBMD in Norwegian girls and boys aged 15\u201317\u00a0years at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The first wave of the Troms\u00f8 study, Fit Futures was conducted from 2010 to 2011. Femoral neck (FN), total hip (TH), and total body (TB) bone mineral content (BMC) and aBMD were measured by dual-energy X-ray absorptiometry. Information on use of snuff, smoking habits, and other lifestyle related variables were collected through self-administered questionnaires. Two years later, during 2012\u20132013, the measurements were repeated in the second wave. The present study included 349 girls and 281 boys and compared \u201cnon-users\u201d (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009243 girls, 184 boys) with \u201cusers\u201d (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009105 girls, 96 boys) of snuff and \u201cnon-smokers\u201d (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009327 girls, 249 boys) with \u201csmokers\u201d (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921 girls, 31 boys) using linear regression adjusted for age, baseline height and weight, change in height and weight, pubertal maturation, physical activity, ethnicity, alcohol consumption, diagnosis known to affect bone, and medication known to affect bone. The influence of \u201cdouble use\u201d on bone accretion was also explored.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In girls, no associations between use of snuff and \u2206aBMD were found. In boys, use of snuff was associated with reduced bone accretion in all \u2206aBMD models. Sensitivity analysis with exclusion of \u201csometimes\u201d users of snuff strengthened associations at femoral sites in girls and attenuated all associations in boys. In girls, no associations between smoking and \u2206aBMD were found. In boys, only the association with TB \u2206aBMD was significant in the fully adjusted models. In girls, \u201cdouble users\u201d analyses showed similar association to smoking. In boys, nearly all models showed statistically significant associations with a difference of\u2009~\u20091\u20132% in \u2206aBMD between \u201cnon-users\u201d and \u201cdouble users\u201d during 2\u00a0years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate that tobacco use in late adolescence could be detrimental to bone accretion and may be a signal of increased fracture risk in adult life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11657-021-01003-7","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T01:02:37Z","timestamp":1632704557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The influence of snuff and smoking on bone accretion in late adolescence. The Troms\u00f8 study, Fit Futures"],"prefix":"10.1007","volume":"16","author":[{"given":"Ole Andreas","family":"Nilsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Emaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tore","family":"Christoffersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Winther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Evensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyrd","family":"Thrane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sofie","family":"Furberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guri","family":"Grimnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luai Awad","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"issue":"9","key":"1003_CR1","doi-asserted-by":"publisher","first-page":"2239","DOI":"10.1007\/s00198-012-1964-3","volume":"23","author":"JA Kanis","year":"2012","unstructured":"Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. 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