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Pharmacokinetic study

The World Health Organisation’s Study Group on Tobacco Product Regulation has listed research needs, including the need for more information on the interaction between smokeless tobacco products and consumers. “Research on and testing of smokeless tobacco products, their use, the consequences of their use and the implications of different policies are essential, so that policies can be set that will improve health and minimise unintended consequences”[1].

We have a programme of research that seeks to provide a greater understanding of smokeless tobacco products, especially Swedish snus, and how such products are used. A consumption study of Swedish snus users that we undertook and published in 2009 found that users of loose snus consumed far more tobacco each day than users of pouched snus, despite research suggesting that the levels of nicotine and its metabolites were similar in loose and pouched snus users. In addition, the World We have a programme of research to provide a greater understanding of smokeless tobacco products, especially Swedish snus, and how such products are used. A consumption study of Swedish snus users in 2009 found that users of loose snus consumed far more tobacco each day than users of pouched snus[2], despite research suggesting that the levels of nicotine and its metabolites were similar in loose and pouched snus users[3].

In 2010 we conducted a clinical study in Sweden to determine the nicotine absorption kinetics of a range of tobacco products and an over-the-counter (OTC) nicotine product. Six products were included in the study: two pouched snus products (1g snus pouches with different nicotine contents), two different portion sizes of loose snus (1g, same weight as pouched snus and 2.5g, median reported portion weight[1]), a cigarette and a nicotine gum (an OTC nicotine replacement therapy). All were commercially available in Sweden when the study began.

The volunteers recruited into the study were healthy dual users of cigarettes and snus. They attended a Clinical Research Unit in Sweden on six occasions to test one product per visit. The concentration of plasma nicotine was determined at intervals for two hours following product use. These data were used to determine pharmacokinetic parameters such as the maximum concentration achieved (Cmax) and the time to reach Cmax (Tmax).

The study results show that, for the snus products, the Cmax measurements are dependent on the total nicotine content of the product.
The study results show that, for the snus products, the Cmax measurements are dependent on the total nicotine content of the product.

The study provided new information on the nicotine absorption kinetics of typical tobacco products and a nicotine gum that are currently available in some countries in Europe, and provides insight as to whether different types of product format (e.g. loose versus pouched snus) result in different kinetics[4].

This study was reviewed and approved by the Swedish Central Ethics Committee and the Medical Products Agency of Sweden. Conduct was in accordance with the relevant articles of the Declaration of Helsinki and Good Clinical Practice. The study was registered with the International Standard for Randomised Controlled Trials - ISRCTN11703777.


  1. WHO Technical Report Series 951 (2008), page 13 . http://www.who.int/tobacco/global_interaction/tobreg/publications/9789241209519.pdf
  2. Digard, H., Errington, G., Richter, A., & McAdam, K. (2009) Patterns and behaviors of snus consumption in Sweden. Nicotine Tob Res. 11(10):1175-81 (Link  ).
  3. Andersson, G., Bjornberg, G., & Curvall, M. (1994) Oral mucosal changes and nicotine disposition in users of Swedish smokeless tobacco products: a comparative study. J.Oral Pathol.Med., 23, 161-167 (Link  ).
  4. Digard, H., Proctor, C., Kulasekaran, A., Malmqvist, U., Richter, A. (2012) Determination of Nicotine Absorption from Multiple Tobacco Products and Nicotine Gum. Nicotine Tob Res (2013) 15 (1): 255-261.  (Link)
 
 
 
 
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