Do never smokers make up an increasing share of snus users as cigarette smoking declines? Changes in smoking status among male snus users in Norway 2003–15

Abstract

AimsTo examine how the relative size of six groups of male ever snus users (current and former users of snus who were current, former or never cigarette smokers) varied over time in Norway, and how these groups differ with regard to important measures of tobacco behaviour.DesignRepeated cross‐sectional nationally representative surveys of tobacco use. The association between survey year and the six categories of ever snus use was examined using cross‐tabulation and multinomial logistic regression. Differences in tobacco behaviour across snus use categories were examined using logistic and ordinary least squares (OLS) regression.SettingNorway, 2003–15.ParticipantsA total of 2067 males aged 15–79 years.MeasurementsThe categories of ever snus use represented all six combinations of cigarette smoking (current, former or never) among current and former users of snus. The variables measuring tobacco behaviour were: order of product uptake (snus or cigarettes first), mean cigarette consumption, reduction from daily to occasional smoking, intention to quit cigarettes, future smoking identity and use of snus in latest quit attempt.FindingsDuring the period 2003–15, the relative share of current snus users who had never smoked, and current snus users who were former smokers, increased. The share of dual users, and smokers who were former snus users, decreased. Among men who reported life‐time experience with both products, a large majority had initiated their tobacco use with cigarettes. The average number of cigarettes smoked weekly was lower among dual users compared with current smokers who were former snus users or had never used snus.ConclusionsDuring the period 2003–15 in Norway, which has a mature snus market, even though smoking has declined and the relative size of the category of never‐smokers among male users of snus has increased, the majority of snus users are still former or current smokers.

The greater use of flavoured snus among ever-smokers versus never-smokers in Norway

“…Our study has shown that the majority of snus users (at least 75%)—whether current or former – were current or former smokers (ever smokers). This finding is consistent with Norwegian studies based on other data sets [ 36 – 38 ]. However, the novel finding from our study is that daily smokers and former daily smokers were more likely to use flavoured snus products compared to snus users without any prior history of smoking.…”

“…In this segment of potential snus users, susceptibility to flavoured products would contribute negatively to public health. However, according to our study-and several others-the largest reservoir of potential snus users have until now been smokers-not never smokers [36][37][38].…”

Relative Risk Perceptions between Snus and Cigarettes in a Snus-Prevalent Society—An Observational Study over a 16 Year Period

“…Up until now, studies have demonstrated that the largest reservoir of potential snus users has been smokers, and that use among never-smokers is small [ 43 ]. Based on current knowledge of the a) absolute risk of snus use relative to non-use, b) the relative risk of snus relative to smoking, and c) how the population of snus users is made up of never-smokers and smokers (the user configuration), dissemination of information to correct misconceptions of relative risk will probably result in a net gain to public health.…”

Association between snus use over time and smoking cessation in Norwegian smokers

“…In 2017, 20% of males and 10% of females were ever snus users . Former smokers constitute the majority of current Norwegian snus users .…”