Role of snus (oral moist snuff) in smoking cessation and smoking reduction in Sweden

Aims To assess to what extent snus has been used as an aid to stop smoking among Swedish smokers. Design A random telephone retrospective survey of Swedish smokers and ex-smokers. Setting Survey conducted in November-December 2000. Participants A national sample of 1000 former and 985 current daily smokers aged 25-55 years. Measurements Smoking status, date and method of quitting by self-report. Findings Thirty-three per cent of former smokers and 27% of current smokers had ever used snus. The difference was larger among men (55% versus 45%, P = 0.003). Current smokers who made use of snus smoked on average fewer cigarettes per day than non-users of snus. The mean duration of abstinence among former smokers was not influenced by snus use. Conditionally on age, education and use of nicotine replacement therapy there was an increased probability of being a former rather than a current smoker with ever use (OR 1.72, 95% Cl = 1.30-2.28) or current use (OR 1.81, 95%, Cl = 1.31-2.53) of snus. Having used snus at the latest quit attempt increased the probability of being abstinent by about 50% (OR 1.54, 95% Cl = 1.09-2.20). Conclusions Our study suggests that by using snus, Swedish male smokers may increase their overall chances of abstinence. However, 71% of the men in this sample who quit smoking did so without using snus and the duration of abstinence was not affected by snus use. This suggests that snus is not a necessary component of smoking cessation at the population level. Snus use was very rare among women.