Brief Survey of Current Oral Tobacco and Nicotine Product Use in Sweden and Denmark

Exclusive use of Swedish snus is associated with a reduction in associated health risks as compared with cigarette smoking. Similar to Swedish snus but without tobacco, modern oral nicotine pouches are smokeless nicotine products with the potential to offer similar or greater reductions of risks associated with tobacco use. Currently, little is known about the use prevalence of these products in established markets for Swedish snus. In this descriptive study, two market research surveys were conducted in 2019 among 18–64-year-olds in Sweden (n = 7003; male, 51.1%) and Denmark (n = 4402; male, 50.5%) on use of these oral tobacco and nicotine products in order to explore basic user demographics and average daily consumption (ADC) of oral nicotine products. In Sweden, 18.5% of participants reported currently using oral products (17.1% snus; 1.4% nicotine pouch), while only 11.0% smoked cigarettes. In Denmark, by contrast, 20.5% of participants reported currently using cigarettes, whereas 3.2% used oral products (0.8% snus; 2.4% nicotine pouch). More men than women reported using oral products in both countries, and most oral product users were younger than 45 years. The ADC of all oral products was 11.1 pouches/day in Sweden, but only 5.6 pouches/day in Denmark, where nicotine pouch use was predominant. In summary, Swedish snus continues to account for most oral tobacco or nicotine product use in Sweden, but nicotine pouch use has surpassed snus use (2.4% vs. 0.8%) in Denmark. Tobacco users who switch to nicotine pouches may reduce their health risks as compared to continuing tobacco product use, and nicotine pouches can contribute to tobacco harm reduction for the population as a whole.