Tobacco harm reduction in the real world: has the availability of snus in Norway increased smoking cessation?

In Norway, snus (low nitrosamine smokeless tobacco) is allowed to compete with cigarettes for market share, and over the past decades the prevalence of snus users has increased as the prevalence of smokers has decreased. The author has aimed to sum up the findings from research that has tried to identify the role of snus in smoking cessation and how availability to snus in Norway has affected the magnitude of concomitant use of snus and cigarettes.\ud \ud Relevant results from Norwegian studies are presented, and, if possible, compared to findings from studies conducted in other countries.\ud \ud Snus is reported by ever-smokers to be the most preferred method for quitting, and former smokers make up the largest segment of Norwegian snus users. The quit rate for smoking is consistently observed to be higher for snus users than for smokers who have no experience of use of snus. Moreover, those using snus are more likely to have quit smoking completely or considerably reduced their cigarette smoking than users of medicinal smoking cessation products. The increase in snus use among men in Norway has not been paralleled by an increase in dual use of snus and cigarettes.\ud \ud The results observed in Norway might not be extrapolated to other countries that do not have the same history of use of snus.\ud \ud The replacement of cigarettes by snus has been the most typical pattern of use in Norway, and the availability of snus may have been beneficial to public health.\ud \ud Engelsk abstract: Besides neighbouring Sweden, Norway is the only country in the eurozone with a tradition of snus use. Knowledge about the pattern of snus use in these countries is relevant for policymakers when deciding the legal status of snus in the EU