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Snus is a traditional Scandinavian smokeless tobacco product, used particularly in Sweden, where it is widely used by men. Snus has been regulated as a food product under the Swedish Food Act since the 1970s.1 It is banned in other EU countries but is available in the US.2

An image of General snus tins and pouches

Image 1: General snus (Source: Swedish Match)


Snus is available loose, or portioned in pouches resembling tiny tea bags (Image 1), and consumed by placing a pinch, or the pouch, or between the gum and upper lip for a period of time.3 Ingredients include tobacco, sodium carbonate, moisturisers, and flavourings.3

Unlike other smokeless tobacco, snus has a relatively high nicotine delivery and absorption, and relatively lower levels of harmful substances.4 The lower levels of toxins are generally attributed to how it is manufactured and stored.5

The so-called ‘Swedish Experience’ attributes Sweden’s low smoking prevalence, and resulting low occurrence of smoking related diseases, to high rates of snus use among Swedish men.

However a 2020 review by Norway’s Institute of Public Health identified a potential underestimation of health impacts.67 A pooled analysis from Sweden, published in 2021, identified an association between snus use among men and increased mortality.8

Snus is commonly used along with cigarettes.91011 Dual use does not effectively safeguard health.12

Research indicates that snus use probably increases the risk of:

  • type 2 diabetes,13
  • oral lesions,1415
  • osophogeal cancer,146 and
  • preterm birth.6161718

Evidence conflicts on the link between snus use and:

  • pancreatic cancer,1419
  • cardio vascular disease, high blood pressure, heart attacks and strokes.6202122

Cigarette companies investing in snus

From 2002, large transnational tobacco companies increasingly invested in snus, and more recently, nicotine pouches which do not contain tobacco leaf.

Philip Morris International (PMI) gained significant interests in both products when it acquired Swedish Match in 2022. 

Tobacco companies have also conducted, commissioned and funded research on these products.232425262728

Swedish Match developed its own quality standard for snus, called Gothiatek.2930

Product regulation

The European ban on snus sales has been repeatedly legally challenged by the industry, and a strong lobby from Sweden.

As of 2022 snus continues to be banned from sale across Europe outside of Sweden. A 2013 TCRG study found there was relatively little control on promotions and illegal snus sales via the Internet.31

Use in Sport

There are concerns that snus may be becoming more popular among some groups of young people, particularly men, outside Sweden.10 Use of snus by footballers who play internationally,3334 has led to both concerns around their own health,3536 and the possible impact of increasing attractiveness to youth.3337

Note that in some cases snus may be confused with nicotine pouches, which do not contain tobacco leaf, especially in countries which do not have a tradition of snus use.

TobaccoTactics Resources

TCRG Research

For a comprehensive list of all TCRG publications, including TCRG research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications.

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  1. Swedish Food Regulations, Food Act (Livsmedelslagen SFS 2006:804), 2006. Available from
  2. U.S. Food & Drug Administration, Smokeless Tobacco Products, Including Dip, Snuff, Snus, and Chewing Tobacco, website, undated, accessed January 2024
  3. abWorld Health Organization, Smokeless tobacco (SLT) products: Snus, website, 10 January 2018, accessed January 2024
  4. Royal College of Physicians, Harm reduction in nicotine addiction: helping people who can’t quit, A report by the Tobacco Advisory Group of the Royal College of Physicians, 2007, RCP: London
  5. J. Foulds, L. Ramstrom, M. Burke, et al, Effect of smokeless tobacco (snus) on smoking and public health in Sweden, Tobacco Control, 2003, 12(4), doi:10.1136/tc.12.4.349
  6. abcdNorwegian Institute of Public Health, Health risks from snus use, 1 November 2019. Available from
  7. G.E. Vist, T.K. Grimsrud, H. Valen et al, Are the health risks of moist oral snuff (snus) underestimated? Tidsskriftet, 4 June 2020, accessed January 2024
  8. M.L. Byhamre, M. Araghi, L. Alfredsson et al, Swedish snus use is associated with mortality: a pooled analysis of eight prospective studies, Int J Epidemiol, 2021 Jan 23;49(6), doi: 10.1093/ije/dyaa197
  9. K. Raitasalo, E.K. Bye, C. Pisinger et al, Single, Dual, and Triple Use of Cigarettes, e-Cigarettes, and Snus among Adolescents in the Nordic Countries, Int. J. Environ. Res. Public Health, 2022, 19, 683, doi:10.3390/ijerph19020683
  10. abM. Danielsson, A. Lammi, S. Siitonen et al, Alarming development of dual snus and cigarette usage among young Finnish males, BMC Public Health, 2019 Sep 11;19(1):1249, doi: 10.1186/s12889-019-7519-1
  11. A.W. Macara, Should doctors advocate snus and other nicotine replacements? No, BMJ, 2008 Feb 16;336(7640):359, doi: 10.1136/bmj.39479.491319
  12. Centers for Disease Control and Prevention, Dual Use of Tobacco Products, website, undated, accessed January 2024
  13. P.G. Persson, S. Carlsson, L. Svanstrom, et al., Cigarette smoking, oral moist snuff use and glucose intolerance, Journal of Internal Medicine, 2000, 248(2), doi:1046/j.1365-2796.2000.00708.x
  14. abcJ. Luo , W. Ye, K. Zendehdel, et al, Oral use of Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in male construction workers: a retrospective cohort study, The Lancet, 2007, 16;369(9578)
  15. A. Roosaar, A.L. Johansson, G. Sandborgh-Englund, et al., A long-term follow-up study on the natural course of snus-induced lesions among Swedish snus users, International Journal of Cancer, 2006, 119(2), doi: 1002/ijc.21841
  16. L.J. England, R.J. Levine, J.L Mills et al, Adverse pregnancy outcomes in snuff users, Am J Obstet Gynecol, 2003 Oct;189(4):939-43, doi: 10.1067/s0002-9378(03)00661-6
  17. A.K. Wikstrom, S. Cnattingius, M.R. Galanti, et al, Effect of Swedish snuff (snus) on preterm birth, BJOG: An International Journal of Obstetrics & Gynaecology, 2010, 117(8), doi:10.1111/j.1471-0528.2010.02575.x
  18. Swedish Match, Pregnancy Outcomes, website, undated, accessed January 2024
  19. M. Araghi, M. Rosaria Galanti, M. Lundberg et al, Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies, J. Cancer, 2017, 141, doi:10.1002/ijc.30773
  20. HanssonN. L. PedersenM. R. Galanti et al, Use of snus and risk for cardiovascular disease: results from the Swedish Twin Registry, Journal of Internal Medicine, May 2009, doi: 10.1111/j.1365-2796.2009.02081.x
  21. B.L. Rostron, J.T Chang, G.M Anic et al, Smokeless tobacco use and circulatory disease risk: a systematic review and meta-analysis, Open Heart, 2018;5:e000846, doi: 10.1136/openhrt-2018-000846
  22. G. Arefalk, K. Hambraeus, L. Lind et al, Discontinuation of Smokeless Tobacco and Mortality Risk After Myocardial Infarction, Circulation, 2014;130, doi:10.1161/CIRCULATIONAHA.113.007252
  23. Swedish Match, Research on Snus, webpage, undated, archived September 2023, accessed January 2024
  24. Environ, Review of the Scientific Literature on Snus (Swedish Moist Snuff), 31 March 2010, available from
  25. P.N. Lee, The effect on health of switching from cigarettes to snus – A review, Regulatory Toxicology and Pharmacology, 2013, Volume 66, Issue 1, doi:10.1016/j.yrtph.2013.02.010
  26. P.N. Lee, Summary of the epidemiological evidence relating snus to health, Regulatory Toxicology and Pharmacology, 2011, Volume 59, Issue 2, doi:10.1016/j.yrtph.2010.12.002
  27. E. Clarke, K. Thompson, S. Weaver et al, Snus: a compelling harm reduction alternative to cigarettesHarm Reduction Journal, 2019, 16, 62, doi:10.1186/s12954-019-0335-1
  28. H. Digard, C. Proctor,A.  Kulasekaran et al, Determination of nicotine absorption from multiple tobacco products and nicotine gum, Nicotine Tob Res,  2013, 15(1), doi:10.1093/ntr/nts123
  29. Swedish Match, Swedish Match Quality Standard, website, archived April 2014, accessed January 2024
  30. Swedish Match, GOTHIATEK®, Swedish Match Quality Standard, website, archived September 2023, accessed January 2024
  31. S. Peeters, A.B. Gilmore, How online sales and promotion of snus contravenes current European Union legislation, Tobacco Control, 2013; 22:266-273
  32. World Health Organisation, WHO report on the global tobacco epidemic 2021: addressing new and emerging products, August 2021
  33. abD. Taylor, How English football got hooked on snus: ‘Players don’t understand the threat of it’, 30 March 2023, accessed January 2024
  34. W. Magee, Why Are Footballers Obsessed with Snus? Vice, 5 April 2023, accessed January 2024
  35. Investigation into nicotine-based snus use by professional footballers, Sky news, 20 September 2023, accessed January 2024
  36. Loughborough University, ‘Snus’ use in football: Loughborough University and Professional Footballers’ Association (PFA) launch joint research project, website news, 19 September 2023
  37. David James: Former England goalkeeper concerned snus is ‘detrimental’ to players’ performances, BBC Sport news, 5 December 2023, accessed January 2024