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