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Are Australian smokers interested in using low-nitrosamine smokeless tobacco for harm reduction?
  1. C E Gartner1,
  2. E V Jimenez-Soto1,
  3. R Borland2,
  4. R J O'Connor3,
  5. W D Hall1
  1. 1The University of Queensland, School of Population Health, Herston, Queensland, Australia
  2. 2Cancer Council of Victoria, Carlton, Victoria, Australia
  3. 3Roswell Park Cancer Institute, Buffalo, New York, USA
  1. Correspondence to Coral E Gartner, School of Population Health, The University of Queensland, Herston Rd, Herston, QLD 4006, Australia; c.gartner{at}


Aims To determine (1) whether Australian smokers are aware of low-nitrosamine smokeless tobacco (LNSLT) products and (2) whether they would be interested in using LNSLT either as a long-term substitute for smoking or as an aid to quitting, if these products were to become legally available.

Methods 401 daily smokers were recruited by a market research company to complete an internet questionnaire about their smoking history, knowledge of smokeless tobacco and intentions to purchase LNSLT under different scenarios.

Findings Just under half (48%) indicated they were willing to buy an LNSLT product. Predictors of an interest in purchasing LNSLT were low income, poorer health, prior SLT use, belief that SLT is less harmful than cigarettes, switching to a lower tar cigarette in the past year, ever using nicotine replacement therapy products for quitting or other reasons, having made a failed cessation attempt in the previous year and not planning to quit smoking. Analysis of quitting and LNSLT purchasing intentions under different scenarios suggest that making LNSLT available at a much lower cost than smoked cigarettes while increasing taxes on cigarettes could provide a greater reduction in the number of smokers than the same tax increase alone. These results support further examination of the potential for LNSLT to reduce smoking-related harm in Australia.

  • Smokeless tobacco
  • tobacco harm reduction
  • tobacco
  • potential reduced exposure products
  • smoking
  • snus
  • public policy
  • smokeless tobacco products
  • taxation and price
  • tobacco products

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  • Funding This study was funded by a new staff start-up grant from the University of Queensland. The funder had no role in the study design, data collection, analysis, writing of the manuscript or decision to publish. CG is supported by an National Health and Medical Research Council Postdoctoral Research Training Fellowship. WH is supported by an National Health and Medical Research Council Australia Fellowship.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of The University of Queensland Human Research Ethics Committee.

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