This is a review paper on the usage of smokeless tobacco, snus. A narrative view of published papers and other date sources (for example, internet-base information) on snus use, use of other tobacco products, and changes in health status in Sweden and Norway. The snus consumption have increased substantially during the recent decades and today more than every fifth male adult uses snus daily in Norway and Sweden. Some of the publications made from snus are written in Scandinavia, and therefore some of the papers are directly translated from Scandinavian into English. It must be emphasized that this is not a study on snus, rather a review paper. This text will shortly be about the dramatic increase in snus usage among adults in Scandinavia, mainly Sweden and Norway the last decade and their short and longterm effects. In the recent times the tobacco industry has been active in developing and marketing new products that might be perceived as less harmful to health than typical cigarettes. At the same time, there has been an increasingly vigorous debate within the public health community over the most appropriate response to the new products being developed by the industry. In this debate, public health advocates have been mindful of the historical precedents set by previous tobacco industry attempts to...

<p><strong>Syfte</strong></p><p>Snusandet har ökat de senaste åren, särskilt bland kvinnor och yngre personer och till flera samhällsgrupper. Rökning har under många år genomgått rigorös forskning och därigenom bevisats vara förenat med ohälsa. Däremot är forskning på snusanvändandets hälsoeffekter eftersatt. En fysiologisk effekt som föreslagits av långvarigt snusande är påverkan på balans (posturalt svaj). Uppsatsens huvudsyfte är att undersöka effekten på balans av ett långvarigt (sex veckor) uppehåll från snus i en grupp av dagligsnusare.</p><p> </p><p><strong>Metod</strong></p><p>I studien genomförde dagligbrukare av snus (n=13) tester av posturalt svaj före och efter sex veckors uppehåll från snus. Undersökningen bestod av sex olika balanspositioner stående på en kraftplatta där amplituden och standardavvikelsen av svajet (tryckcentrumsförflyttning) i sidled (mediolateralt) och framåt-bakåt (anterio-posteriort). En referensgrupp av icke tobaksbrukare (n=15) genomförde samma tester, med minst en dags mellanrum, för att mäta den normala dag-till-dag-variationen i posturalt svaj. Dessutom mättes blodtryck, hjärtfrekvens och kroppsvikt.</p><p><strong> </strong></p><p><strong>Resultat</strong></p><p>Det posturala svajet påverkades i stort inte av att långtidssnusare gjorde ett snusuppehåll på sex veckor. Det fanns inga signifikanta förändringar i amplitud vid någon av de sex positionerna i någon riktning (p-värde mellan 0,09 till 0,92). Standardavvikelsen på rörelsen var signifikant förändrad vid två av tolv mätningar. Dock var de absoluta skillnaderna av samma storleksordning som dagsvariationen vid mätningarna på referensgruppen, och anses därför fysiologiskt obetydliga. Övriga fysiologiska förändringar var att hjärtfrekvensen i vila sänktes med 6±10 slag/minut (p=0,002) och att försökspersonerna gick upp i vikt med 1,7±1,7 kg (p=0,003).</p><p> </p><p><strong>Slutsats</strong></p><p>Ett uppehåll i snusandet på sex veckor hade försumbar effekt på balansen i stillastående, mätt som posturalt svaj, hos personer som snusat dagligen under lång tid. Däremot innebar snusuppehållet en sänkning av hjärtfrekvensen i vila och en ökning av kroppsvikten.</p><p><strong>Abstract </strong><strong>Aim</strong> The use of Swedish moist snuff has increased in recent years, especially among women and younger people and to several community groups. Smoking has, based on numerous research studies, since long been associated with illness and death. However, research on moist snuff use is neglected. A physiological effect that has been proposed by long-term use of moist snuff is affected balance (postural sway). The main purpose of this paper is to investigate the affect of long-term (six weeks) withdrawal from use of Swedish moist snuff on balance.</p><p> </p><p><strong>Method </strong><strong></strong>In the study daily users of snuff (n=13) conducted tests of postural swaying before and after the six week withdrawal from moist snuff. The investigation consisted of six different equilibrium positions standing on a force plate in which the amplitude and standard deviation of sway (center of pressure movement) in the sideways (mediolateral) and forward-backward (anteriorposterior). A reference group of non-tobacco users (n=15) performed the same tests, with at least one day apart, in order to measure the normal day-to-day variation in postural sway. In addition, blood pressure, heart rate and body weight were measured.</p><p> </p><p><strong>Results </strong>The postural sway in long-term snuff users was principally not affected by six weeks of withdrawal from snuff. There were no significant changes in amplitude for any of the six positions in any direction (p-values between 0.09-0.92). The standard deviation of movement altered in two out of twelve measurements. However, the absolute difference was of the same magnitude as the day-to-day variance in the measurements of the reference group, and is therefore considered physiologically negligible. Other physiological changes were that the heart rate at rest was decreased by 6±10 bpm (p=0.002) and that the subjects gained weight by 1.7±1.7 kg (p=0.003).<strong></strong></p><p><strong>Conclusion </strong></p><p>A withdrawal from the use of Swedish moist snuff for six weeks had negligible effect on the balance of the stagnation, as measured by the postural swaying, of persons who used Swedish moist snuff daily for a long time. However, a pause from using moist snuff resulted in a reduction in heart rate at rest and an increase in body weight.</p>

Syftet med föreliggande studie var att undersöka effekterna av ett längre uppehåll från tobaks- och nikotinbruk på maximal aerob effekt och energiomsättning under submaximalt arbete hos regelbundet snusande personer.   Metod 23 snusare (18 män, 5 kvinnor) undersöktes före och efter &gt;6 veckors uppehåll från snus (SSP). Försökspersonerna genomförde ett stegrande submaximalt arbete på cykelergometer, ett maximalt löptest och ett uthållighetsarbete bestående av 60 minuter cykling på 50 % av VO2max. Syreupptag (VO2), ventilation (VE), subjektivt skattad ansträngning på Borgs RPE-skala (RPE), hjärtfrekvens (HF) och blodtryck (BT) mättes. Blodprov togs för analys av kotinin, laktat [HLa], blodglukos och fria fettsyror (FFA) i vila och under arbete.   Resultat Submaximalt VO2 och energiomsättning påverkades inte av &gt;6 veckors uppehåll från snus. VE, respiratorisk kvot (RQ), blodglukos och RPE var oförändrade under det stegrande submaximala arbetet. Post-SSP sågs däremot en viss förändring i koncentrationen av [HLa], genom signifikant lägre [HLa] under den sista arbetsbelastningen (7,61 ± 3,01 resp. 7,18 ± 2,95 mmol/l, p&lt;0,05). HF och BT var signifikant lägre vid alla submaximala arbetsbelastningar. Genomsnittlig löptid i det maximala testet, uppnått maximalt syreupptag (VO2max), maximal HF och [HLa] var i princip identiska före och efter uppehåll från snus. Under långtidsarbetet var FFA, HF och BT signifikant lägre och det fanns en tendens till lägre ventilatorisk drift post-SSP. Det fanns ingen signifikant påverkan på övriga mätningar under långtidsarbetet. Andra observerade fysiologiska förändringar var viktökning (1,5 ± 1,6 kg, p&lt;0,01) och sänkt HF i vila (61 ± 9 slag/min pre-SSP, 55 ± 8 slag/min post-SSP, p&lt;0,05).   Slutsats Syreupptagning vid submaximalt aerobt arbete som involverar stora muskelgrupper påverkas inte av ett längre uppehåll från regelbundet snusbruk. VO2max och maximal aerob prestationsförmåga var oförändrade. Exponering för snus kan ha en viss inverkan på metabolismen under arbete, vilket främst visades genom lägre koncentrationer av FFA post-SSP. / The aim of the present study was to examine the effects of a prolonged cessation from tobacco and nicotine on maximal aerobic power and energy metabolism during submaximal exercise in regular snuff users.   Methods 23 snuff users (18 men, 5 women) were investigated before and after a &gt;6 week snuff cessation period (SCP). Participants performed a submaximal graded exercise test on cycle ergometer, a maximal running test and a prolonged aerobic endurance test consisting of 60 minutes cycling on 50 % of VO2max. Measurements of oxygen uptake (VO2), ventilation (VE), rate of perceived exertion on Borg´s RPE-scale (RPE), heart rate (HR) and blood pressure (BP) were obtained. Blood samples were drawn for analysis of cotinine, lactate [HLa], blood glucose, and free fatty acids (FFA) at rest and during exercise.   Results Submaximal VO2 and energy expenditure were not affected by &gt;6 weeks of withdrawal from snus. VE, respiratory exchange ratio (RER), blood glucose and RPE during submaximal graded exercise test remained unchanged. However, post-SCP a small change was observed in the [HLa] concentration, due to a significantly lower [HLa] at the final stage in the test (7.61 ± 3.01 and 7.18 ± 2.95 mmol/l, respectively, p&lt;0.05). HR and BP were significantly reduced at all submaximal work rates. Mean time to exhaustion during the maximal running test, maximal oxygen uptake (VO2max), maximal HR and [HLa] were almost identical before and after SCP. Significantly lower values of FFA, HR and BP, and a tendency towards lower ventilatory drift during prolonged submaximal exercise were observed post-SCP. No changes were observed on any other measurements during the prolonged exercise test. Other physiological changes were weight gain (1.5 kg ± 1.6 kg, p&lt;0.01) and decreased HR (61 ± 9 beats/min pre-SCP, 55 ± 8 beats/min post-SCP, p&lt;0.05) at rest.   Conclusions Oxygen uptake in submaximal aerobic exercise with large muscle groups is not affected by a prolonged cessation from regular snuff dipping. VO2max and maximal aerobic performance is unchanged. Exposure to snus may have some influence on the metabolism during exercise, mainly characterized by lower concentrations of FFA post-SCP.

Syfte Snusandet har ökat de senaste åren, särskilt bland kvinnor och yngre personer och till flera samhällsgrupper. Rökning har under många år genomgått rigorös forskning och därigenom bevisats vara förenat med ohälsa. Däremot är forskning på snusanvändandets hälsoeffekter eftersatt. En fysiologisk effekt som föreslagits av långvarigt snusande är påverkan på balans (posturalt svaj). Uppsatsens huvudsyfte är att undersöka effekten på balans av ett långvarigt (sex veckor) uppehåll från snus i en grupp av dagligsnusare.   Metod I studien genomförde dagligbrukare av snus (n=13) tester av posturalt svaj före och efter sex veckors uppehåll från snus. Undersökningen bestod av sex olika balanspositioner stående på en kraftplatta där amplituden och standardavvikelsen av svajet (tryckcentrumsförflyttning) i sidled (mediolateralt) och framåt-bakåt (anterio-posteriort). En referensgrupp av icke tobaksbrukare (n=15) genomförde samma tester, med minst en dags mellanrum, för att mäta den normala dag-till-dag-variationen i posturalt svaj. Dessutom mättes blodtryck, hjärtfrekvens och kroppsvikt.   Resultat Det posturala svajet påverkades i stort inte av att långtidssnusare gjorde ett snusuppehåll på sex veckor. Det fanns inga signifikanta förändringar i amplitud vid någon av de sex positionerna i någon riktning (p-värde mellan 0,09 till 0,92). Standardavvikelsen på rörelsen var signifikant förändrad vid två av tolv mätningar. Dock var de absoluta skillnaderna av samma storleksordning som dagsvariationen vid mätningarna på referensgruppen, och anses därför fysiologiskt obetydliga. Övriga fysiologiska förändringar var att hjärtfrekvensen i vila sänktes med 6±10 slag/minut (p=0,002) och att försökspersonerna gick upp i vikt med 1,7±1,7 kg (p=0,003).   Slutsats Ett uppehåll i snusandet på sex veckor hade försumbar effekt på balansen i stillastående, mätt som posturalt svaj, hos personer som snusat dagligen under lång tid. Däremot innebar snusuppehållet en sänkning av hjärtfrekvensen i vila och en ökning av kroppsvikten. Abstract Aim The use of Swedish moist snuff has increased in recent years, especially among women and younger people and to several community groups. Smoking has, based on numerous research studies, since long been associated with illness and death. However, research on moist snuff use is neglected. A physiological effect that has been proposed by long-term use of moist snuff is affected balance (postural sway). The main purpose of this paper is to investigate the affect of long-term (six weeks) withdrawal from use of Swedish moist snuff on balance.   Method In the study daily users of snuff (n=13) conducted tests of postural swaying before and after the six week withdrawal from moist snuff. The investigation consisted of six different equilibrium positions standing on a force plate in which the amplitude and standard deviation of sway (center of pressure movement) in the sideways (mediolateral) and forward-backward (anteriorposterior). A reference group of non-tobacco users (n=15) performed the same tests, with at least one day apart, in order to measure the normal day-to-day variation in postural sway. In addition, blood pressure, heart rate and body weight were measured.   Results The postural sway in long-term snuff users was principally not affected by six weeks of withdrawal from snuff. There were no significant changes in amplitude for any of the six positions in any direction (p-values between 0.09-0.92). The standard deviation of movement altered in two out of twelve measurements. However, the absolute difference was of the same magnitude as the day-to-day variance in the measurements of the reference group, and is therefore considered physiologically negligible. Other physiological changes were that the heart rate at rest was decreased by 6±10 bpm (p=0.002) and that the subjects gained weight by 1.7±1.7 kg (p=0.003). Conclusion A withdrawal from the use of Swedish moist snuff for six weeks had negligible effect on the balance of the stagnation, as measured by the postural swaying, of persons who used Swedish moist snuff daily for a long time. However, a pause from using moist snuff resulted in a reduction in heart rate at rest and an increase in body weight.

Abstract The purpose of this study is to examine alcohol and tobacco habits in men's soccer in the in Sweden and compare those habits in different divisions. The method we used in the study was aquantitative survey report. Two teams participated in the survey, one team from the fifth divisionand one from the second division. The respondents (n=34) are born between 1977 and 1996. The results turned out to be very interesting because it both confirm and denies our hypothesis that players in higher divisions use less tobacco and alcohol than players in lower divisions. For example we found out that 21 % of division two players use snus regularly compared with only 10 % of division five players. We have also examined alcohol habits in both a general way and also compared those habits between the divisions, and we have also investigated how and if alcohol is consumed during parties that are held at the season finales. / Syftet med den här studien är att undersöka hur alkohol- och tobaksvanorna ser ut inom herrfotbollen och jämföra hur de skiljer sig mellan olika divisioner. Metoden vi använde oss av i studien var en kvantitativ enkätundersökning. Det var två lag som deltog i undersökningen, ett lag från division fem och ett lag från division två. Respondenterna (n=34) är födda mellan år 1977 och 1996. Resultaten visade väldigt intressant fakta som både bekräftar och dementerar vår hypotes om att spel i högre divisioner leder till mindre nyttjande av tobak och alkohol. Till exempel så framkom det att en större andel division två-spelare (21%) snusade regelbundet jämfört med division fem-spelarna (10%). Vi har även sett över hur alkoholvanorna ser ut både generellt och divisionerna emellan samt om och hur alkohol konsumeras under lagens säsongsavslutning.

Syfte: Syftet med studien var att kartlägga tobaksvanor och uppfattningen om tobakens påverkan i munhålan bland grundlärarstuderande. Material och metod: En tvärsnittsstudie med kvantitativ design genomfördes i form av en enkätundersökning. Enkäten delades ut till 76 grundlärarstudenter där samtliga valde att delta. Resultat: Resultatet visade att det var 13 respondenter som rökte och 4 som snusade, varav en var blandbrukare av snus och cigaretter. Debutåldern för rökning var mellan 11-20 år och för snusning mellan 16-20 år. Den övervägande delen av respondenterna hade uppfattningen att tobak har någon form av påverkan i munhålan. En stor del av respondenterna uppfattade att rökning har en mycket stor betydelse för att utveckla tillstånden dålig andedräkt (73,3%) och missfärgning av tänderna (78,9%), medan majoriteten av respondenterna uppfattade att missfärgning av tänderna (82,7%) har en mycket stor betydelse vid användningen av snus. Slutsats: Resultatet visar att det var fler tobaksanvändare i denna studie i förhållande till tobaksvändningen i övriga Sverige. Studien visar att den övervägande delen av grundlärarstudenterna uppfattade att rökning och snusning påverkar utveckling av olika tillstånd i munhålan. / Objective: The aim of the study was to identify tobacco habits and the perception of its effects in the oral cavity among elementary teacher students at Kristianstad University. Material and methods: A cross-sectional study with quantitative design was performed with a questionnaire survey. It was distributed to 76 elementary teacher students where all participated. Results: The results showed that 13 respondents smoked and 4 used snus, one of those was using both cigarettes and snus. The debut age for smoking was between 11-20 years and 16-20 years when using snus. The vast majority of the respondents perceived that the use of snus and cigarettes effects the oral cavity. Many of the respondents perceived that smoking had very great importance in the development of halitosis (73,3%) and discoloration of the teeth (78,9%), while the majority of the respondents had the perception that the discoloration of the teeth (82.7%) was of very great importance in the use of snus. Conclusion: The result shows that there were more tobacco users in this study in relation to tobacco use in the rest of Sweden. This study shows that the vast majority of the elementary teacher students perceived that smoking and snus had an effect for developing various states in the oral cavity.

Bakgrund: Tobak är den enskilt största livsstilsfaktorn som leder till ohälsa. Att tobak är skadligt och leder till flertalet svåra sjukdomar är idag känt bland de flesta. Trots detta röker fortfarande 10% av Sveriges befolkning och ca 800 000 snusar. Inom sjukvården röker en av tio sjuksköterskor dagligen. Sjuksköterskan ses som en nyckelperson för patienten inom tobaksprevention och bör vara en förebild. Patientens sjukhusvistelse ses därför som ett bra tillfälle att lyfta frågan om att sluta med tobak. Sjuksköterskor som röker har visats vara sämre på att ge råd och vara mindre benägna att hjälpa sina patienter att sluta röka vilket strider mot den yrkesverksamma sjuksköterskans arbetsuppgift, vilken är att främja hälsa och förebygga sjukdom. Syfte: Syftet med denna studie var att undersöka användandet av tobak bland sjuksköterskestudenter vid Uppsala universitet samt studenternas syn på användning av tobak som yrkesverksamma sjuksköterskor. Metod: En kvantitativ metod valdes då ett stort antal personer skulle undersökas och en studiespecifik enkät skickades ut till totalt 632 sjuksköterskestudenter. Resultat: Av studenterna använde 38% tobak. Av dessa rökte 3,1% dagligen och 12% snusade dagligen. Studenterna ansåg att sjukvårdspersonal är förebilder i hälsoförebyggande vård och sjuksköterskor som använder tobak ansågs inte vara bra förebilder. Slutsats: Den dagliga rökningen var mindre bland sjuksköterskestudenterna jämfört med tidigare undersökningar gjorda på sjuksköterskor. Studenterna såg sjuksköterskor som förebilder för patienten inom hälsa och anser att sjukvårdspersonal bör värna om sin egen hälsa och inte bruka tobak. Det sågs en skillnad mellan studenterna som använde tobak och de som inte använde tobak.  Studenterna som inte använde tobak ansåg att en sjuksköterska som använder tobak inte är en bra förebild för patienterna och de ansågs vara mindre benägen att hjälpa patienterna att sluta med tobak. Medan de studenter som använde tobak ansåg oftare att detta inte hade någon betydelse för vården. Men de studenter som rökte planerade ändå att sluta tills de skulle ta sin examen. / Background: Tobacco is the single largest lifestyle factor leading to a bad health. That smoking is harmful and leads to many serious diseases are known among most people. Despite this 10% of the Swedish population and about one out of ten nurses at the hospital still smoke daily. Nurses are supposed to be role models and play a key role in tobacco use prevention. The patient’s time at the hospital is therefore seen as a good opportunity to raise the question about tobacco cessation. Nurses who smoke are proven to be less likely to provide advice and help these patients stop using tobacco, which is opposing the nurses tasks, to promote health and to prevent illness Aim: The purpose of this study was to investigate the use of tobacco among the nursing students at Uppsala university and the students opinion about the use of tobacco as professional nurses. Method: A quantitative method was chosen because of the large number of people that would be examined and as study specific questionnaire was sent out to a total of 632 nursing students. Results: In total 38% of students used tobacco. Among those, 3.1% were daily smokers and 12%used Swedish snus. The students considered nurses as role models for the patient in health. Nurses who used tobacco were seen as poor role models. Conclusion: The daily smoking is declining among the nursing students compared to previous studies on nurses. The students considered nurses as role models for the patients in health and they believe that hospital workers should care about their own health and not use tobacco. A difference was found between the students who used tobacco and those who did not use tobacco. The students who did not use tobacco considered that a nurse who uses tobacco is not a good role model and for the patients and are considered as not as good in giving tobacco cessation advice. The students who used tobacco thought more often that the nurses use of tobacco did not matter for the care he or she gives. At the same time the students who smoke still plan to quit smoking before graduation.

Denna uppsats syftar till att via en genomgång av policydokument och kompletterande telefonintervjuer undersöka motiven bakom införandet av ett förbud mot så väl snus som cigaretter på arbetstid genom s.k. Tobaksfri arbetstidi sexton svenska kommuner samt att undersöka hur dessa kommuner skiljer sig åt. Vidare är ambitionen att med hjälp av statsvetenskapliga modeller för policyanalys ge en inblick i policyprocesserna i de undersökta kommunerna.  Resultatet av studien är att ett tobaksförbud i de undersökta kommunerna införts utifrån ett antal olika motiv, där hälsoaspekter och ekonomiska aspekter är de mest framträdande, men att det när det gäller förbud av snus mer specifikt ofta saknas tydliga motiv och vetenskapliga grunder, samt resonemang kring förbudets konsekvenser.

Parental reports are often used in studies of asthma and allergic diseases in children. A change in respondent from parent to index subject usually occurs during adolescence. Little is known about the effects this change in method might have on the outcomes of a longitudinal study. Smoking is a major cause of respiratory symptoms among adults and environmental tobacco smoke (ETS) is a risk factor for asthma among children. Less is known about these associations among teenagers. In order to improve prevention of smoking, it is important to identify populations at risk of becoming smokers.       The aim of this thesis were to 1) evaluate the methodological change from parental to self-completion of a questionnaire about asthma and allergic diseases, and 2) to study determinants for, and respiratory health effects of ETS and personal smoking in teenagers. In 1996, a longitudinal study of asthma and allergic diseases among schoolchildren started within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. All children in first and second grades (aged 7-8 years) in three municipalities, Luleå, Kiruna and Piteå (n=3,525) were invited and 97% participated by parental completion of a questionnaire. The cohort has been followed with annual questionnaires until age 16-17 years and with high participation rates (&gt;91%). From age 12-13 years, the teenagers were the respondents and questions about their tobacco use were included. In addition to the questionnaire completed by the teenagers at age 13-14 years, a questionnaire was also distributed to a random sample of 10% of the parents and 294 participated (84%).   The parents and the teenagers reported a similar prevalence of asthma, respiratory symptoms, rhinitis, eczema and environmental factors. Two statistically significant differences were found: the teenagers reported a higher prevalence of wheezing during or after exercise (14% vs 8%, p&lt;0.05), and having a dog in the home in the last 12 months (42% vs 29%, p&lt;0.001). Answer agreement between parents and teenagers on questions about asthma was almost perfect with kappa values of 0.8-0.9. Corresponding kappa values for questions about respiratory symptoms and rhinitis were 0.3-0.6 and for eczema 0.5-0.6. Agreement about environmental factors varied from 0.2-0.9. Kappa values for parental smoking were 0.8-0.9. The risk factor pattern for allergic diseases was similar regardless of respondent, ie parent or teenager. The prevalence of smoking increased from 3% at 12-13 years to 6% at 14-15 years. Smoking was more common among girls, while the use of snus was more common among boys. Significant risk factors related to smoking among teenagers were smoking family members, female sex and living in an apartment. Having physician-diagnosed asthma did not prevent the teenagers from becoming smokers. Factors related to using snus were a smoking mother and male sex.  Daily smokers aged 16-17 years (9%) reported a significantly higher prevalence of wheezing and physician-diagnosed asthma compared to non-smokers. There was a significant dose-response association with higher prevalence of wheeze among those who smoked ≥11 cigarettes per day compared to those who smoked ≤10 per day. In multivariate analyses, maternal environmental tobacco smoke exposure was a significant risk factor for ever wheeze and physician-diagnosed asthma at age 16-17 years, while daily smoking was a risk factor for current wheeze. In conclusion, the methodological change of questionnaire respondent from parent to index subject did not substantially alter the findings of this longitudinal study. There were significant sex differences in the tobacco use: smoking was more common among girls and snus was more common among boys. The most important factor related to tobacco use was presence of family members who smoke. Both maternal ETS exposure and personal smoking was associated with asthma and wheeze in adolescence. ETS was associated with lifetime symptoms but daily smoking was more strongly associated with current symptoms.

<p>Mergers between companies has become more and more common in Sweden and in the rest of the world with the motive to increase the competitive strength in the current markets and has an important role within organisational development of companies. When organisations merger there is not only buildings and objects that are put together but also their individual organisational structures, people, values and cultures. This can be a difficult process and can affect many people in how they think conscious as well as unconscious, feel and react.</p><p>The purpose of this thesis is to gain a deeper understanding of how employees are affected following a merger when changes in the organisational culture come up, and how these changes are expressed.</p><p>This thesis is delimited to investigate only one company, Skruf Snus AB and only focus on their business and employees in the region of Stockholm. The thesis contains a qualitative investigation with semi structured interviews that has been carried out with eight employees at Skruf Snus AB. The thesis is partly based on a model of Schein which describes the different levels in organisational culture and partly on some theories about reactions to change in relation to the integration between the employees following a merger.</p><p>The results of the investigation indicate that with a merger the whole organisational culture is affected and therefore also the employees. Routines, communication, loyalty and relations have been changed. A gain of stress, anxiety, sadness and disappointment appears between the employees. This is often a result of lack of information and indistinct directives. Concepts like “Us and Them” are created, both unconscious and conscious and are permeated through the entire organisation.</p>