To investigate snus consumption behaviour in Sweden, a telephone survey of around 3,000 snus users - 2,555 males and 359 females - was conducted between March and April of 2007 [ 1 ].
The survey addressed various topics, from average consumption per day and residence time in mouth to dependence and use of snus as a cessation aid.
The male population was relatively evenly distributed between use of ‘loose snus’ (42%) and ‘portion snus’ (54%). The female population predominantly used ‘portion snus’ (93%). Few used both loose and portioned snus.
Male consumption of ‘portion snus’ was 11.8 grams per day on average while the female group consumed 8.5 grams per day on average. Male users of ‘portion snus’ consumed 12 pouches a day on average compared to 10 pouches a day for female ‘portion snus’ users. ‘Loose snus’ consumption was 29.5 grams per day on average [ 2 ] .
Almost 70% of the ‘portion snus’ users said they keep the pouch in their mouth for more than 35 minutes. Subsequent reassessment of this question showed the median residence time in the mouth is around 60 minutes.
22% of male snus users took their first snus within five minutes of waking, and 57% of males took their first snus within thirty minutes of waking. The data were similar for females.
The survey also found that around 47% of males and females had used snus as a way to stop cigarette smoking.
In May 2005, British American Tobacco South Africa began a test launch of snus in a limited number of outlets in Johannesburg, South Africa. Snus was at the time unknown as a product in South Africa and there was a low level of use of oral tobacco generally. The predominant form of tobacco use is cigarettes [ 3 ].
The snus products were identified using well known cigarette brands. A reasonable amount of press coverage accompanied the launch - carrying a general message that snus use was risky but less harmful than cigarette smoking. The products carried the warning “Causes Cancer” and communication materials throughout the year-long test focused on how to use the product rather than why.
Verified adult smokers - including those who tried snus and those who refused to do so - were interviewed about their perceptions of the relative levels of harm caused by snus and cigarettes at three different times.
Soon after the test launch, 19% of trialists reported that they thought snus more harmful than cigarettes, 38% thought snus equally harmful and only 10% thought snus less harmful. 32% were unsure.
The percentage of trialists who thought snus was equally or more harmful than cigarettes grew from 57% at first interview, to 63% at second interview and 68% at the time of the third interview.
Of adult smokers who would not try snus, 63% thought snus to be equally or more harmful than cigarettes, rising to 79% at the time of third interview.
The study suggested that - in the absence of clear communication on relative risks - adult smokers unfamiliar with snus are likely to see it as equally or more hazardous than cigarette smoking, despite the lack of smoke.