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Correlates of the use of different nicotine strengths in smokeless tobacco (snus) and oral nicotine pouches among the Finnish general population
  1. Otto Ruokolainen,
  2. Hanna Ollila,
  3. Karoliina Karjalainen
  1. Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
  1. Correspondence to Dr Otto Ruokolainen; otto.ruokolainen{at}thl.fi

Abstract

Introduction Snus and oral nicotine pouches (ONPs) include different levels of nicotine, yet little is known about their correlates of use. Our aim was to study the correlates of use of snus and ONPs with different nicotine levels.

Methods We used population-based Drug Survey 2022, including 15–69-year-old respondents (n=3857, response rate 47%). Persons who had ever used the products were included in further analyses (29% (n=1611) according to snus use and 14% (n=589) according to ONP use). Outcomes included self-reported strength of snus (normal, strong, extra strong and do not know)/ONPs (≤ 4 mg, > 4 mg and do not know) and covariates included demographic, tobacco and substance use-related variables. Logistic regression analyses were used.

Results 31% of persons who had ever used snus reported using snus labelled as normal and 43% of persons who had ever used ONPs reported using lower nicotine-level ONPs. About one-third of respondents did not know the nicotine content of the used product. For stronger snus use, multivariable models showed an association with male gender, younger age, current/former snus use, hazardous alcohol and lifetime cannabis use, while younger age and current use of snus and e-cigarettes were associated with stronger ONP use.

Discussion Not knowing the nicotine level of the used snus or ONPs was common among the Finnish population having used the products. Younger age and the use of snus are associated with the use of stronger snus and ONPs. The nicotine levels and addictiveness of oral tobacco and nicotine products should be regulated.

  • Nicotine
  • Non-cigarette tobacco products
  • Surveillance and monitoring

Data availability statement

Data may be obtained from a third party and are not publicly available. The data used in this study are not publicly available, but it will be available in Finnish Social Science Data Archive where it can be accessed with a research proposal and an approved user authorisation application. https://www.fsd.tuni.fi/en/.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The data used in this study are not publicly available, but it will be available in Finnish Social Science Data Archive where it can be accessed with a research proposal and an approved user authorisation application. https://www.fsd.tuni.fi/en/.

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Footnotes

  • Contributors OR, HO and KK conceptualised and designed the study. KK did the data management. OR, HO and KK designed the methodology. KK conducted the analyses. OR wrote the first draft of the manuscript. All authors contributed to manuscript revisions and have approved the final version of the article. OR acted as a guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests OR and HO have acted as paid consultants for WHO Regional Office for Europe on a report on snus.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.