Snuff is a finely milled tobacco product that contains nicotine; users typically place a "pinch" or "dip" between their lip and gum. A study in the October issue of the American Journal of Preventive Medicine reports that although daily snuff users are more likely than other men to have quit smoking, U.S. men are far more likely to have switched from snuff to cigarettes.
Scott L. Tomar, D.M.D., Dr.P.H., of the University of Florida College of Dentistry, says his study refutes research suggesting that snuff may be a useful harm reduction tool in public health efforts to discourage smoking.
"The prevalence of smoking was substantially higher among men who had quit using snuff than among those who had never used snuff, suggesting that more than 40 percent of men who had been snuff users continued or initiated smoking," Tomar says. He indicates that snuff use might impede smokers' efforts to quit.
Tomar analyzed data from the 1998 National Health Interview Study, an annual nationwide survey by the Centers for Disease Control and Prevention that asks respondents about various health-related behaviors. (1998 is the most recent year in which the survey asked about smokeless tobacco use.) Because so few women use snuff, Tomar focused on data for men age 18 and older. The 1998 NHIS found that 26.4 percent of U.S. men smoked, 3.6 percent used snuff, and 1.1 percent used both forms of tobacco.
Tomar notes that men in the United States were more than 2.5 times as likely to have switched from snuff to cigarettes than to have switched from cigarettes to snuff. While few men gave up smoking for snuff use, many more men dropped snuff use and took up smoking, a finding that suggests snuff may act as a gateway substance for nicotine use, Tomar says.
Compared with smokers who had never used snuff, those who used it daily generally smoked fewer cigarettes per day than smokers who had never used snuff, and they were more likely to have tried to quit smoking. The findings suggest that some smokers who would like to quit are using snuff as an alternative method of nicotine administration.
Comparing smokers' use of snuff to the rise in popularity of low-tar cigarettes, Tomar said that "smokers who might otherwise have quit may have chosen instead to switch to products that they perceived as less harmful." He noted that, as with low-tar cigarettes, "supplementation of smoking with snuff may have reduced smokers' success in quitting smoking while probably not appreciably reducing their risk for smoking-associated disease."
The author points out that this study is limited because it is based on self-reported data and tobacco users tend to underreport their consumption. In addition, the NHIS did not report tobacco users' reasons for choosing different types of tobacco products.
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American Journal of Preventive Medicine