Rising Uptake of Alternative Nicotine Products (ANPs) by Smoking-Naïve Individuals Is Not Necessarily a Threat to Public Health: The Case of Diversion by Snus in Norway

Categories: Data, Posters, Uncategorized

Selya A and Lund KE.

Background​: Adults who smoke tobacco can benefit by switching to less-harmful alternative nicotine products (ANPs). However, ANP uptake by smoking-naïve people is a concern​. Several publications have reported increasing rates of ANP use by smoking-naïve individuals. However, these concerns seems at odds with historic declines in tobacco smoking in many cases.

Data: Smoking Habits Survey, 1985-2022​
Annual cross-sectional survey of tobacco behavior conducted by Statistics Norway​
Sample: Individuals aged 16-74​

Prevalence trends in current (daily or occasional) snus use and current tobacco smoking (cigarettes or roll-your-own). Trends in % of snus users who: 1) did not currently smoke tobacco, and 2) never smoked tobacco daily.

Prevalence trends are suggestive of snus displacing tobacco smoking in Norway over 1985-2022​. Especially among men, for whom snus use surpassed smoking​. Over the displacement process, there were increases in the proportion of snus users who 1) did not currently smoke (~40% to 80%) and 2) never smoked daily (~20% to 35%). This increase is a natural mathematical consequence of rising snus use & falling smoking rates.

Rising uptake of ANPs by smoking-naïve individuals is not necessarily a concern​. It can be, if ANP use adds to tobacco smoking.​ OTOH, it can be a favorable indicator that naturally follows from ANPs displacing more harmful combustible tobacco​. Interpreting trends in ANP use by nonsmoking individuals is ambiguous in and of itself​. Population-level prevalence trends are necessary to disambiguate these opposing interpretations​. These findings may extend to other reduced-risk ANPs.

Selya A. Lund KE. Adults who smoke tobacco can benefit by switching to less-harmful alternative nicotine products(ANPs