Oral tobacco products: preference and effects among smokers

Background: Recently, oral tobacco products have been marketed specifically towards cigarette smokers. These products come in different nicotine doses and formulations (snus vs. lozenge). To date, little research has been conducted to determine how smokers respond to these products. The goal of this study was to examine if smokers prefer certain oral tobacco products based on their specific characteristics.

Methods: Smokers interested in quitting underwent a sampling phase and a treatment phase. The sampling phase consisted of testing five different products varying in nicotine dose (high vs. moderate vs. low) and formulation (snus vs. lozenge): General Snus, Camel Snus, Marlboro Snus, Stonewall and Ariva. Each product was sampled in the natural environment on separate days. At the end of the sampling period, subjects chose which product they would use during the 2-week cigarette abstinence phase.

Results: General Snus (high nicotine) was not preferred by any smoker. No significant differences in preferences were observed across the other tobacco products. During the smoking cessation phase, Camel Snus was generally associated with greater craving relief and satisfaction, reduced use of cigarettes, and greater abstinence during follow-up compared to other products.

Conclusion: There were no differences in preferences for four of the five oral tobacco products but higher nicotine oral tobacco products were associated with better cessation outcomes among smokers who chose these products.