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Snus

Snus is a heat-treated moist snuff tobacco product originating from Sweden in the early 19th century, composed primarily of ground air-cured tobacco leaves, water, salt, and sometimes sodium carbonate, formed into loose or portioned pouches placed under the upper lip for nicotine absorption without combustion or spitting.^[1]^[2] Developed from earlier forms of oral snuff dating back to the 16th century, snus gained prominence in Sweden during the 20th century, with consumption peaking in the early 1900s before stabilizing; today, daily use among Swedish men stands at approximately 22%, while female use is around 4%, contributing to a parallel decline in cigarette smoking prevalence from higher levels in prior decades to about 6% recently.^[3]^[4]^[5] Empirical analyses indicate that snus substitution for smoking has averted thousands of premature deaths annually in Sweden by reducing exposure to smoke-related carcinogens.^[6] Multiple studies demonstrate that snus poses substantially lower risks for key health outcomes—such as lung cancer, cardiovascular disease, and overall mortality—compared to cigarette smoking, though it is not risk-free and carries associations with oral and pancreatic cancers at elevated but diminished levels relative to combustible tobacco.^[7]^[8]^[9] Legally, snus remains uniquely permitted for sale in Sweden within the European Union due to a protocol exemption upon accession, while banned elsewhere in the EU since 1992 despite evidence of its harm-reduction potential, reflecting regulatory divergences prioritizing precautionary bans over comparative risk assessments.^[10]^[11]

Definition and Composition

Core Characteristics

Snus is a pasteurized, moist smokeless tobacco product originating from Sweden, consisting of ground air-cured tobacco leaves mixed with water, salt, and sodium carbonate to achieve a pH of approximately 8 to 8.5.^[12] ^[13] It is designed for oral use by placing a portion under the upper lip, where nicotine is absorbed through the mucous membranes without combustion, spitting, or inhalation.^[14] Unlike fermented smokeless tobaccos such as American moist snuff, snus undergoes steam pasteurization during production, which reduces levels of tobacco-specific nitrosamines (TSNAs).^[12] Traditional Swedish snus maintains a moisture content of about 45-55%, contributing to its soft texture and facilitating nicotine release.^[12] Total nicotine concentrations typically range from 7 to 20 mg per gram of product (wet weight), with un-ionized (freebase) nicotine levels elevated due to the alkaline pH, enhancing buccal absorption efficiency compared to lower-pH products.^[15] The product is available in loose form for manual portioning or pre-portioned sachets, often flavored with bergamot, herbs, or fruits to mask tobacco taste while preserving discreet, odor-minimal use.^[16] Snus differs from other oral tobaccos like chewing tobacco or nasal snuff in its non-fermented processing, portioned delivery to minimize mess, and emphasis on controlled nicotine delivery without expectoration.^[16] This formulation results in lower moisture variability and TSNA content relative to non-pasteurized smokeless products, as documented in comparative chemical analyses.^[17]

Ingredients and Formulation

Snus is primarily composed of finely ground tobacco leaves that are air-cured or sun-cured to develop flavor and reduce nitrosamine precursors, blended with water to achieve a moisture content typically ranging from 20% to 60%.^[18]^[1] Salt, in the form of sodium chloride at concentrations of approximately 1.5% to 3.5%, is added to enhance flavor and act as a preservative, while sodium carbonate serves as an alkalizer to raise the pH to an alkaline level (usually 8.0 to 8.5), facilitating nicotine release and absorption through the oral mucosa.^[19]^[2] Additional minor ingredients include humectants such as glycerin or propylene glycol to maintain moisture and prevent drying, along with flavorings derived from natural sources like herbs, fruits, or spices to impart varieties such as mint, bergamot, or citrus notes.^[1] Unlike fermented smokeless tobaccos, snus formulation avoids fermentation; instead, the tobacco mixture undergoes pasteurization through steaming or heating to eliminate harmful bacteria like Clostridium botulinum while preserving the product's moist texture and low levels of tobacco-specific nitrosamines (TSNAs) when produced under standards like GothiaTek.^[1] This process results in a product where tobacco constitutes the bulk (often over 40% by dry weight), with nicotine levels varying from 4 to 20 mg per gram depending on the brand and strength designation.^[20]^[2] Variations in formulation exist between Swedish-style snus and American adaptations, with the latter sometimes exhibiting higher TSNA concentrations (e.g., NNN + NNK levels up to 2.5 times greater) due to differences in tobacco curing or processing, though both share core components of tobacco, salt, and pH adjusters.^[2] Swedish snus adheres to stricter quality controls, limiting additives and ensuring pasteurization, which contributes to its distinct chemical profile compared to dry snuffs or chewing tobacco.^[1]

Production and Variants

Manufacturing Process

The manufacturing process of snus, a moist oral tobacco product originating in Sweden, emphasizes pasteurization over fermentation to minimize bacterial growth and tobacco-specific nitrosamines (TSNAs).^[18]^[21] This heat treatment, typically conducted at 70-80°C, distinguishes snus from other smokeless tobaccos like American dip, which often rely on fermentation that can elevate TSNA levels.^[21]^[2] Swedish producers adhere to standards such as GOTHIATEK®, which imposes strict limits on contaminants like heavy metals and TSNAs throughout the chain, using non-genetically modified, air- or sun-dried tobacco varieties selected for low initial levels of undesired substances.^[18] The process commences with tobacco grinding, where dried leaves are broken down into coarse, intermediate, and fine particles, often to a powder finer than 0.5 mm for uniformity.^[18]^[21] The ground tobacco is then transferred to closed blenders and mixed with water, salt (sodium chloride for taste and preservation), and sodium carbonate to adjust pH levels, achieving a moist consistency.^[18]^[22] This blend undergoes pasteurization in computer-controlled vessels, where it is heated to eliminate nitrite-forming microbes and pathogens, followed by rapid cooling to preserve moisture and prevent overcooking.^[22]^[21]^[2] Post-pasteurization, humectants such as propylene glycol (typically 3-5%) or glycerol are incorporated to maintain moisture and texture, alongside natural or artificial flavorings for aroma development.^[22]^[21] The mixture is then aged in cold storage—often at around 4°C for several days to 1-2 weeks—allowing flavors to mature without further microbial activity.^[18]^[21] For loose snus, the final product is filled into paraffin-coated cardboard cans, sealed, weighed, and labeled; portioned variants involve metering the blend into heat-sealable cellulose fiber pouches (approximately 0.7 g each), sealing and cutting them, then packing into polypropylene cans.^[18]^[22] Throughout, automated quality controls monitor nicotine content, moisture (around 30-50%), and pH (typically 8.0-8.5) to ensure consistency and compliance with food safety regulations like Sweden's Food Act.^[18]^[21]

Types of Snus

Snus is primarily classified into two formats: loose snus and portioned snus. Loose snus consists of finely ground, moist tobacco that users manually portion into a small wad or ball for placement under the upper lip.^[23] This traditional form allows customization of size and shape to individual preference, with moisture content typically around 30-50% to facilitate nicotine release without combustion.^[24] Portioned snus, introduced in the 1970s, comes pre-packaged in small, teabag-like cellulose or synthetic pouches containing ground tobacco, eliminating the need for manual handling.^[23] Original portions, the earliest variant launched in 1973, feature moist tobacco that promotes saliva production and a steady nicotine drip, often resulting in a fuller flavor release but potential teeth staining from the darker tobacco.^[25] White portions, developed later for reduced drip, use drier tobacco with added salt and flavorings, yielding a whiter appearance, less moisture leakage, and slower nicotine absorption to minimize oral irritation.^[23] White dry portions further reduce moisture levels, enhancing discretion and comfort during use.^[25] Portion sizes vary within these categories, including large or original (about 1 gram per pouch for robust users), slim (narrower for subtle fit), and mini (smaller, 0.5 grams or less for beginners or extended wear).^[25] While flavors such as mint, bergamot, or tobacco dominate across types, and nicotine strengths range from mild (4-8 mg/g) to extra strong (20+ mg/g), these attributes modify rather than redefine the core formats.^[26] American snus variants, often drier and pasteurized differently, diverge from Swedish standards but retain similar loose or portioned structures.^[24]

Usage Practices

Consumption Method

Snus is consumed orally by placing the product—a pre-formed pouch or a user-measured pinch—between the upper lip and the adjacent gum, enabling trans-mucosal absorption of nicotine without ingestion, chewing, or expectoration.^[27]^[28] This placement leverages the oral mucosa's vascularity for nicotine delivery, with effects onset typically within 1-2 minutes and peaking around 5 minutes.^[29]^[30] For portioned snus, which constitutes the majority of modern variants, the user extracts a single pouch from its container and positions it under the upper lip, often offset to one side for optimal fit and minimal interference with speech or swallowing.^[31]^[32] The pouch remains in place for 5 to 60 minutes, adjusted based on desired nicotine yield and flavor intensity, after which it is discarded without reuse.^[27]^[28] Users are advised against swallowing the pouch or its contents to prevent gastrointestinal discomfort.^[27] Loose snus usage involves dispensing a small quantity—typically 1-2 grams—directly from the can, which the user may lightly compact or shape into a wad before inserting it under the upper lip in a manner analogous to portioned forms.^[28]^[33] This format permits customization of portion size, potentially yielding a more rapid or intense nicotine release compared to fixed pouches.^[33] Placement duration mirrors that of portions, though loose material may conform more readily to the oral contours.^[28] The upper lip is the standard site for both formats due to lower salivary flow relative to the lower lip, which minimizes drip, extends flavor and nicotine persistence up to an hour, and reduces irritation risk.^[34]^[35] Lower lip placement, while feasible, accelerates release and increases saliva production, often leading to quicker disposal.^[36] No preparation such as moistening is required, as snus arrives in a humidified state optimized for immediate use.^[28]

User Demographics and Cultural Context

Snus use is concentrated in Sweden and Norway, where it exhibits the highest prevalence rates in Europe, with daily usage among adults reaching approximately 16% in Sweden and 15% in Norway as of 2022.^[37] In Sweden, usage remains predominantly male-dominated, with 20.7% of men and 3.5% of women reporting smokeless tobacco use in surveys from the early 2010s, though recent data indicate a narrowing gender gap, particularly among younger cohorts where female daily nicotine pouch use (often overlapping with snus variants) has risen to 15% among those aged 16-29 compared to 11% for men.^[38] ^[39] Age patterns show peak prevalence among working-age adults, with snus use 1.7 times higher among 40-year-olds than 60-year-olds among men, and even more pronounced among women at younger ages.^[40] Outside Scandinavia, prevalence drops sharply due to regulatory bans; for instance, snus use in other European countries averages below 1%, while in the United States, it remains niche, primarily among tobacco enthusiasts or Swedish expatriates, with no widespread demographic penetration reported in national surveys.^[38] In Norway, daily snus use among men stood at 18.2% in 2010, declining slightly in gender disparity by 2018 as female uptake increased to over 10%, reflecting broader trends in smokeless tobacco substitution for cigarettes.^[41] Overall, snus users skew toward former or current smokers, with 45% of daily users in European cohorts having quit smoking, underscoring its role as a harm-reduction alternative rather than a primary initiation product among never-smokers, who comprise less than 25% of users across usage categories.^[42] Socioeconomic factors influence uptake, with higher rates among manual laborers and urban dwellers historically, though contemporary data highlight its cross-class appeal in Nordic societies.^[40] Culturally, snus embodies a centuries-old Scandinavian tradition originating in 16th-century Sweden, where tobacco was moistened with salt and water for sublingual placement, evolving from elite courtly snuff to a staple among industrial workers during the 19th-century urbanization.^[3] This shift aligned with practical needs for discreet, smoke-free nicotine delivery during work breaks, embedding snus in everyday routines and social bonds, often shared among friends as a marker of camaraderie and national identity.^[43] In Sweden, it has contributed to the lowest EU smoking rates, with 19% of men and 4% of women using it daily as of 2013, positioning snus as a culturally accepted public health divergence from combustible tobacco.^[44] Norway mirrors this, with snus supplanting cigarettes post-World War II, driven by consumer preference for flavored, portioned variants that fit modern lifestyles.^[45] Beyond Nordics, snus lacks deep cultural roots, often viewed through regulatory lenses rather than tradition, limiting its social integration elsewhere.^[46]

Health Effects

Risks Relative to Smoking

Snus use entails substantially lower health risks than cigarette smoking primarily due to the absence of combustion, which eliminates exposure to tar, carbon monoxide, and numerous volatile carcinogens produced by burning tobacco.^[13] Epidemiological data from Sweden, where snus has displaced smoking among many men, demonstrate that tobacco-attributable mortality rates are the lowest in the European Union, with snus users exhibiting reduced incidence of smoking-related diseases such as lung cancer and chronic obstructive pulmonary disease compared to smokers.^[47]^[48] Relative risks for respiratory conditions are negligible with snus, as it involves no inhalation of smoke; cohort studies confirm no significant association with lung cancer, contrasting sharply with the elevated risks from smoking.^[13] For cancers of the oral cavity, pharynx, and esophagus, exclusive snus use shows no demonstrable increase in risk in large Swedish cohorts, unlike the strong causal link with smoking; a systematic review of exclusive snus users found relative risks near unity for these sites when compared to non-users, far below those for smokers.^[49]^[50] Pancreatic cancer risk may be modestly elevated with heavy snus use (≥7 cans/week), but remains lower than for smokers based on dose-response analyses.^[51] Cardiovascular disease risks, including fatal myocardial infarction and stroke, are elevated for both snus users and smokers relative to non-tobacco users, yet comparative analyses indicate snus confers a statistically lower hazard; for instance, adjusted relative risks for cardiovascular mortality are approximately 1.2–1.4 for snus versus 2.0 or higher for smoking in pooled Swedish cohorts.^[52]^[53] Overall mortality follows a similar pattern: snus use is linked to increased all-cause mortality (hazard ratio ~1.3–1.5 versus non-users), but this is markedly attenuated compared to smoking (hazard ratio ~2.0–3.0), supporting snus as a harm reduction tool in populations switching from cigarettes.^[54]^[52] These findings persist after controlling for confounders like age and prior smoking history, though some studies note potential confounding from dual use or cessation dynamics.^[55]

Specific Adverse Outcomes

Snus use is associated with the development of oral mucosal lesions, such as snuff-induced lesions or white patches (snuslesions), which occur due to direct contact with the mucosa and are characterized by keratinization and inflammation.^[56] These lesions are typically reversible upon cessation but can persist in long-term users, with histological changes including epithelial hyperplasia and dysplasia in some cases, though progression to malignancy is rare for Swedish snus.^[57] Studies indicate no significant elevation in oral cancer risk among exclusive Swedish snus users compared to non-users, as evidenced by meta-analyses showing relative risks near unity after adjusting for confounders like smoking.^[58] ^[13] Regarding pancreatic cancer, early cohort studies among Swedish construction workers suggested a potential twofold increased risk, but larger pooled analyses of multiple cohorts, including over 400,000 participants followed for up to 33 years, found no association (hazard ratio 0.96, 95% CI 0.83-1.11) after adjustment for smoking and other factors.^[59] ^[60] Similarly, systematic reviews confirm no consistent link for Swedish snus, distinguishing it from higher-risk smokeless products like Indian gutkha.^[50] Cardiovascular effects include acute elevations in heart rate and blood pressure during use, particularly in older users, due to nicotine's sympathomimetic actions.^[61] Long-term studies show mixed results: while overall cardiovascular disease mortality may not be elevated, snus use in never-smokers is linked to increased stroke risk, especially ischemic stroke (hazard ratio approximately 1.3-1.6 in cohort data).^[53] ^[62] Pooled analyses also report higher all-cause and cardiovascular mortality among snus users (e.g., hazard ratio 1.28 for all-cause in men), though risks remain substantially lower than for smoking.^[54] Snus delivers nicotine, fostering dependence comparable to cigarette smoking, with cross-sectional surveys showing similar levels of nicotine dependence scores (e.g., half of daily users reporting low to high dependence).^[63] ^[64] Withdrawal symptoms upon cessation include irritability and cravings, and long-term follow-up indicates many users maintain habitual use post-smoking cessation attempts.^[65] Other potential outcomes include possible increased risk of esophageal cancer, though evidence is limited and probabilistic rather than definitive.^[57]

Empirical Evidence from Long-Term Studies

A prospective cohort study of 278,897 Swedish construction workers followed from 1971 to 2009 found no significant association between snus use and increased risk of oral cancer, with relative risks of 0.79 (95% CI: 0.52–1.21) for ever-users and 1.02 (95% CI: 0.62–1.70) for current users compared to never-users of tobacco. The same study reported a relative risk of 0.45 (95% CI: 0.24–0.85) for lung cancer among current snus users, suggesting a protective or neutral effect potentially due to substitution from smoking. For pancreatic cancer, the relative risk was 0.82 (95% CI: 0.52–1.30) for current users, indicating no elevated risk relative to non-users. A 2023 systematic review of 22 studies on exclusive Swedish snus users, including cohort and case-control designs spanning decades, concluded no consistent evidence of increased risk for oral, esophageal, gastric, pancreatic, or lung cancers, with most relative risks near or below 1.0 after adjusting for confounders like smoking history.^[50] However, the review noted limited data on long-term exclusive use and potential underpowering for rare outcomes.^[50] Swedish population data from 1987–2013 showed snus users had oral cancer incidence rates comparable to never-tobacco users, contrasting with elevated rates among smokers.^[7] In cardiovascular outcomes, a cohort of 43,396 Swedish men followed from 1991–2014 linked current snus use to a hazard ratio of 1.28 (95% CI: 1.15–1.43) for fatal myocardial infarction, particularly among heavy users (>4 cans/week, HR 1.60), though no association with non-fatal MI or overall CVD incidence after multivariable adjustment.^[53] The study observed no increased risk for major heart diseases, valvular issues, or abdominal aortic aneurysm.^[62] A separate analysis of 169,236 men from 2002–2018 found snus associated with higher all-cause mortality (HR 1.26, 95% CI: 1.15–1.39) and cardiovascular death (HR 1.28, 95% CI: 1.09–1.51) among never-smokers, potentially mediated by nicotine's effects on hemodynamics.^[66] Long-term Swedish registries indicate snus substitution has contributed to national lung cancer rates 50–70% lower than EU averages, with modeling estimating 25–30% of the decline attributable to snus displacing cigarettes since the 1970s.^[6] A counterfactual analysis projected that absent snus, smoking-attributable mortality in Sweden would have been 10–20% higher through 2020, based on cohort data linking snus to higher smoking cessation rates (quit ratios 1.5–2.0 times higher for snus users).^[67] Some evidence suggests elevated post-diagnosis cancer mortality among snus users (HR 1.2–1.4 for all cancers combined), though confounded by dual use or detection bias in Nordic cohorts.^[57] Overall, these studies underscore snus risks as substantially lower than smoking for cancer but highlight dose-dependent cardiovascular concerns.^[8]

Regulation and Market Dynamics

Legal Frameworks by Region

In the European Union, the sale of tobacco-based snus has been prohibited since the adoption of the 1992 Tobacco Products Directive, which aimed to restrict novel oral tobacco products due to concerns over health risks and gateway effects to smoking, though empirical evidence on these risks remains debated relative to combustible tobacco.^[68] Sweden secured a permanent exemption upon its 1995 accession to the EU, allowing domestic manufacture and sale under national regulations, including age restrictions to 18 years and health warnings on packaging.^[69] ^[70] Non-EU Norway permits snus sales, taxing it at NOK 1.28 per gram and enforcing an 18-year purchase age, contributing to high prevalence as a smoking alternative.^[71] ^[45] Post-Brexit, the United Kingdom retained the EU ban, prohibiting commercial sale and marketing of snus under the Tobacco and Related Products Regulations 2016, though personal possession and import for individual use remain permissible without quantity limits specified for travelers.^[72] ^[73] In North America, snus is legal in the United States, classified as a tobacco product under FDA jurisdiction since 2009, requiring premarket authorization for marketing claims; as of November 2024, eight General snus variants hold modified risk tobacco product status, allowing claims of reduced harm compared to cigarettes for adult smokers, with sales restricted to those 21 and older.^[74] ^[75] In Canada, snus falls under the Tobacco and Vaping Products Act, permitting personal import but prohibiting commercial sales without Health Canada authorization, which has not been granted as of 2025, effectively limiting availability to cross-border purchases.^[76] ^[77] Australia and New Zealand maintain outright bans on snus importation, sale, and use, enacted under strict tobacco control laws prioritizing elimination of non-combustible options despite their lower carcinogen profiles relative to smoking. Globally, snus is authorized for sale in 77 to 79 countries, primarily outside the EU, including the United States, Norway, and various nations in Africa, Asia, and South America, while banned in 39 jurisdictions dominated by EU members.^[78] ^[79]

Recent Developments and Trade Challenges

The global snus market expanded to an estimated USD 3.01 billion in 2023, with projections indicating growth to USD 4.10 billion by 2030 at a compound annual growth rate of 4.7%, fueled by demand for reduced-risk nicotine products amid declining cigarette use.^[80] In Nordic countries, snus adoption has accelerated the shift away from smoking; Norwegian data from Statistics Norway reveal that increasing snus prevalence over the past decades has paralleled a sharp drop in smoking rates, from over 30% in the 1990s to under 10% by 2023.^[45] Regulatory hurdles continue to impede snus trade, most notably the European Union's longstanding ban on its sale outside Sweden, enacted in 1992 under the Tobacco Products Directive and upheld despite evidence of snus's harm reduction potential relative to combustible tobacco.^[68] This restriction confines Swedish exports primarily to permitted markets like the United States and Switzerland, while fostering cross-border smuggling within the EU, as nicotine products evade harmonized controls.^[81] In 2025, Sweden escalated challenges to analogous restrictions on tobacco-free nicotine pouches—often termed "white snus"—by formally objecting to proposed bans in France and Spain, contending that such national measures infringe the EU single market's free movement of goods and risk stifling innovation in lower-risk alternatives.^[69]^[82] The Swedish government highlighted that France's comprehensive prohibition on white snus products would unduly limit intra-EU trade, echoing critiques of the original snus ban's disproportionate impact on evidence-based harm reduction strategies.^[83] Meanwhile, EU-wide regulatory fragmentation persists, with member states imposing varied taxes and classifications on pouches, complicating manufacturers' compliance and market access.^[84] In the United States, the Food and Drug Administration has authorized certain snus products via premarket tobacco product applications, enabling market penetration and contributing to overall sector expansion, though youth uptake of related nicotine pouches has prompted heightened scrutiny.^[85] These developments underscore ongoing tensions between public health objectives and trade liberalization, with Sweden advocating for science-driven policies over blanket prohibitions.^[86]

Historical Development

Origins in Scandinavia

Snus, a moist smokeless tobacco product placed under the upper lip, traces its roots to Sweden, where the term "snus" first appeared in a 1637 customs document recording imports from Porvoo, Finland.^[3] Tobacco itself arrived in Sweden around 1638 via shipments from the short-lived Swedish colony on the Delaware River in North America, initially used in pipe smoking and nasal snuff forms common across Europe.^[87] By the mid-17th century, domestic cultivation began in regions like Skåne, Gränna, and Alingsås, supported by figures such as Jonas Alströmer, who promoted agricultural innovations including tobacco alongside potatoes.^[88] In the early 18th century, Swedish users adapted dry nasal snuff into a moist, ground tobacco variant, creating the precursor to modern snus by mixing tobacco leaves with water and salt for sublingual placement, which offered convenience for workers and farmers avoiding the mess of snuff.^[89] This evolution addressed practical needs in a society where tobacco farming expanded to approximately 70 towns by the late 1700s, reflecting widespread adoption amid growing domestic production.^[87] The form stabilized further in the early 1800s, incorporating potash alongside salt and water to enhance flavor and moisture retention, distinguishing it from drier snuffs and establishing its core composition.^[1] Though concentrated in Sweden, early snus practices influenced neighboring Scandinavian countries like Norway, where similar oral tobacco use emerged through cultural exchange, but Sweden remained the epicenter due to its extensive tobacco infrastructure and innovations in moist preparation.^[88] By the 19th century, snus had become a staple among Swedish laborers, underscoring its origins as a pragmatic alternative to smoking in an era of limited fire safety and ventilation in rural and industrial settings.^[87]

Modern Commercialization and Global Spread

The modern commercialization of snus in Sweden gained momentum in the mid-20th century through innovations aimed at improving usability and hygiene. In 1973, the first pre-portioned snus product, named "Smokeless," was launched to assist smokers in quitting by offering a discreet alternative.^[90] This development was followed in 1977 by the introduction of white-portion snus with the Tre Ankare brand, which reduced staining and dripping, enhancing consumer appeal.^[91] Swedish Match, originating from tobacco operations established in 1915 under Sweden's state monopoly, consolidated its position as the dominant producer after merging match and tobacco divisions in 1992 and adopting the Swedish Match name in 1994.^[92] The company further advanced product standards by implementing the GothiaTek quality framework in the late 1990s, which minimized contaminants like nitrosamines through controlled pasteurization and ingredient selection.^[1] Global expansion faced significant regulatory obstacles, notably the European Union's Directive 92/41, enacted in 1992, which prohibited the sale of oral tobacco products including snus across member states to curb perceived risks from novel smokeless variants like U.S.-style products.^[68] Sweden secured a unique exemption for domestic sales upon its EU accession in 1995, preserving its market while banning exports to other EU countries.^[93] Undeterred, Swedish Match targeted non-EU markets, entering a joint venture with Philip Morris International in February 2009 to develop and market snus products internationally, with a primary focus on the United States.^[94] This partnership facilitated the 2016 U.S. launch of ZYN, a tobacco-derived nicotine pouch variant, which achieved substantial sales growth amid rising demand for reduced-risk alternatives.^[95] Further milestones included the U.S. Food and Drug Administration's October 2019 authorization for Swedish Match to market eight snus products with modified risk claims, stating they pose a lower risk of cancer compared to cigarettes for adult smokers switching completely.^[96] Snus consumption remains robust in non-banned regions like Norway, where per capita use rivals Sweden's, and has expanded in markets such as Switzerland and select Asian countries through legal sales channels.^[97] The global snus market, valued at USD 3.01 billion in 2023, reflects ongoing commercialization driven by portioned formats and harm reduction perceptions, projecting growth to USD 4.10 billion by 2030 at a 4.7% CAGR, largely fueled by North American and Scandinavian demand.^[80] Despite proliferation, access in banned jurisdictions often relies on informal imports or tourism, underscoring persistent trade barriers.^[98]

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Sep 12, 2023 · Use snus orally and avoid using pouches in other ways. · Keep the pouch in for a minimum of 5 minutes and a maximum of 60 minutes. · Refrain from ...
[28]
How to Use Snus in a Few Simple Steps - MySnus.com
Take the portion out of the can. · Place the portion under the upper lip, wherever it's most comfortable (for most people, that's slightly on the left or right ...
[29]
How Long Does Snus Last? | Northerner UK Guide
Jul 3, 2025 · Snus generally kicks in within 1–2 minutes of placing the pouch under your lip, with peak nicotine release occurring around the 5-minute mark.
[30]
https://snusdaddy.com/inspiration/how-long-do-nicotine-pouches-last
[31]
How to use snus - 3 illustrated steps on how to snus - SnusDirect.com
In order to use portion snus, you simply take the portion in your hand and lift your upper lip. Then place the snus portion under your lip and leave it there.
[32]
How to Use Snus & Nicotine Pouches – A Beginner's Guide - Haypp
Mar 12, 2025 · Using snus or nicotine pouches is simple: place it under your lip, enjoy the nicotine release, and dispose of it properly. Whether you're new to ...
[33]
3 main differences between loose snus and portion snus
Loose snus is flexible and since you are able to choose the size and shape you could experiment yourself to the perfect snus feeling. 2. Stronger nicotine rush.
[34]
https://snuscore.com/blogs/news/why-place-nicotine-pouches-under-the-upper-lip
[35]
https://snusline.com/blog/why-does-it-make-a-difference-where-i-place-my-snus/
[36]
Where Do You Place a Nicotine Pouch? - Nicopods.ie
Apr 25, 2024 · Shortened Release Duration: The higher moisture level under the lower lip can expedite the release of contents, causing them to be absorbed more ...
[37]
Patterns and Determinants of Exclusive Smokeless Tobacco (Snus ...
Jun 6, 2024 · Among adult populations in Sweden and in Norway during 2011 and 2022, the daily use of snus has increased from 10% to 16% and from 8% to 15%, ...
[38]
Smokeless tobacco use in Sweden and other 17 European countries
Apr 5, 2016 · Estimates from Sweden in 2004–05 showed that 27% of male and 5% of female adults used snus . The 2012 Eurobarometer survey showed a prevalence ...
[39]
https://www.statista.com/topics/13475/snus-market-in-sweden/
[40]
Who is using snus? - Time trends, socioeconomic and geographic ...
The prevalence of smoking in Sweden has decreased in recent decades, and is now among the lowest in the world. During the same period, the use of Swedish moist ...
[41]
Increasing similarities between young adults' smoking and snus use ...
Oct 6, 2020 · In 2010, the gender difference was large, with 18.2% of men being daily snus users, compared to 10.9% of women. In 2018, the difference was ...
[42]
The greater use of flavoured snus among ever-smokers versus ...
Oct 16, 2020 · In all five categories of ever snus use, never smokers comprised 25.3% or less. 45.3% of daily snus users reported to be former daily smokers ...
[43]
Snus culture history: royal courts to working hands - Snusforumet
Oct 9, 2023 · Sweden's snus culture history traces its journey from a royal luxury to a worker's staple, also closely tied to friendship and the identity of people.
[44]
Sweden has fewer smokers than any other European country. This ...
Jun 21, 2017 · Roughly 19% of Swedish men use snus on a daily basis, while 4% of Swedish women do, according to 2013 data.<|control11|><|separator|>
[45]
How snus is replacing smoking in Norway: a revolution led by ...
Snus has been the most common type of smokeless tobacco used in Norway since the Second World War, but prior to that plug tobacco for chewing had been the most ...
[46]
The Swedish experience: How the snus tradition helped the country ...
Apr 24, 2025 · At the heart of the Swedish experience is snus, a derivative of snuff and a long-standing albeit odd cultural phenomenon.
[47]
Mortality attributable to tobacco among men in Sweden and other ...
Among men in the European Union Member States the lowest level of mortality attributable to tobacco was consistently found in Sweden, while Swedish women showed ...
[48]
Assessment of Swedish snus for tobacco harm reduction
It has been suggested that the low rates of tobacco-related mortality in Sweden reflect the lower risks of snus compared with smoking. Tobacco harm reduction ...
[49]
Snus: Swedish snus is different | British Dental Journal - Nature
Jan 25, 2019 · There is strong epidemiological evidence that snus use is not associated with a demonstrable increase in oral cancer risk.
[50]
A systematic review of cancer risk among users of smokeless ...
Jul 21, 2023 · The main objective of this systematic review was to assess cancer risk, and mortality after cancer diagnosis, for exclusive users of Swedish snus, compared ...
[51]
Beyond smoking: Risk assessment of nicotine in pouches
Meta-analysis of five cohort studies investigating snus consumption revealed an increased incidence of type 2 diabetes after intake of ≥ 7 cans per week, but no ...
[52]
Full article: Health Risks of Smoking Compared to Swedish Snus
Both snus use and cigarette smoking were associated with statistically significant elevations in risk of dying from cardiovascular diseases. However, when the ...
[53]
Swedish snuff (snus) and risk of cardiovascular disease and mortality
May 7, 2021 · In the present study, an increased risk of CVD death among snus users with no history of cigarette smoking was observed after adjustment for age ...
[54]
Swedish snus use is associated with mortality: a pooled analysis of ...
Dec 22, 2020 · Snus use among men is associated with increased all-cause mortality, cardiovascular mortality, with death from other causes and possibly with increased cancer ...
[55]
Swedish snuff (snus) dipping, cigarette smoking, and risk of ... - Nature
Jul 15, 2022 · Cigarette smoking but not Swedish snus dipping was associated with an increased risk of PAD. Compared with never snus dippers, the hazard ratio of PAD was 0.95.
[56]
Assessment of a 72-hour repeated exposure to Swedish snus ...
A substantial number of studies provided conflicting evidence on the adverse effects of snus use on oral health, mainly due to confounding factors in ...
[57]
Health risks from snus use - NIPH - FHI
Nov 1, 2019 · Use of Swedish snus probably increases the risk of oesophageal and pancreatic cancer. It is possible that use of Swedish snus increases the risk of cancer of ...<|separator|>
[58]
No association between moist oral snuff (snus) use and oral cancer
May 28, 2020 · Snus use was furthermore not associated with oral-cancer risk in analysis ... risk: A systematic review and meta-analysis of case-control studies.<|separator|>
[59]
Use of moist oral snuff (snus) and pancreatic cancer - PubMed
Aug 15, 2017 · Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83-1.11) after adjustment for smoking.
[60]
Use of moist oral snuff (snus) and pancreatic cancer: Pooled ...
May 9, 2017 · Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83–1.11) after adjustment for ...
[61]
Cardiovascular disease - Swedish Match
They found that during daytime both snus users and smokers, who were 45 years of age or older, had increased heart rate and increased diastolic blood pressure.
[62]
Swedish snuff (snus) and risk of cardiovascular disease and mortality
May 7, 2021 · Current Swedish snus use was not associated with the risk of major heart and valvular diseases, abdominal aortic aneurysm, or CVD mortality in the entire study ...
[63]
Factors predicting willingness to quit snus and cigarette use among ...
Sep 13, 2023 · The level of dependence was similar for smokers and snus users: half of daily smokers and snus users reported low nicotine dependence and a ...
[64]
A Comparison of Dependence across Different Types of Nicotine ...
In summary, this cross-sectional study found that cigarettes and snus are about equally dependence forming and higher than that from NR. Coffee was associated ...
[65]
Snus cessation patterns - a long-term follow-up of snus users in ...
Sep 10, 2020 · Over 80% found snus of great importance to succeed with smoking cessation and half of them continued to use snus on a long term.
[66]
Snus use and mortality : associations, potential mechanisms, and ...
Nov 4, 2022 · We conclude that snus use is associated with increased all-cause and cardiovascular mortality, and to death by other causes, that may be restricted to external ...<|separator|>
[67]
Effect of smokeless tobacco (snus) on smoking and public health in ...
Conclusions: Snus availability in Sweden appears to have contributed to the unusually low rates of smoking among Swedish men by helping them transfer to a ...
[68]
Snus: EU Ban on Snus Sales - Tobacco Tactics
Jun 9, 2021 · The EU banned snus sales (except in Sweden) to prevent the introduction of an addictive product with adverse health effects, and to prevent the ...
[69]
Sweden moves to stop nicotine pouches meeting the fate of snus
Oct 9, 2025 · However, when Sweden joined the bloc in 1995, it secured an exemption allowing snus to be sold legally within its borders.
[70]
How the Swedish model can power a smoke-free EU - EU Reporter
Oct 11, 2025 · Consequently, an exception was made for Sweden. In all other EU countries, the sale of snus is prohibited. Nevertheless, the 1994 accession ...
[71]
REGULATIONS ACROSS THE NORDIC AND BALTIC COUNTRIES
As of 1 January 2025, the legal age for purchasing and using nicotine pouches is 20 years (Saeima, 2016). Nicotine pouches are subject to a tax of €138 per kg ...
[72]
Is Snus Legal in the UK? (2025) - Northerner.com
Apr 10, 2025 · The sale and marketing of snus have been prohibited in the UK since 1992 under the EU Tobacco Products Directive (TPD), retained post-Brexit ...
[73]
Is Snus Legal or Illegal in the UK? What the 2025 Rules Mean for You
Sep 2, 2025 · Snus in the UK Post-Brexit Although the UK has since left the EU, the ban on selling snus remains in force under The Tobacco and Related ...
[74]
FDA Renews Authorization for 8 General Snus Products to be ...
Nov 7, 2024 · Agency's action allows General Snus products to be marketed with a specific claim about reduced risk.Missing: legality | Show results with:legality
[75]
Understanding the Regulation of Snus in the USA - Snusline
Apr 5, 2023 · Snus in the USA is regulated by the FDA via MRTP, with strict marketing rules, state-specific regulations, and import restrictions for personal ...
[76]
Is Snus Legal in Canada? Current Regulations & Standards
Aug 11, 2025 · Is snus legal in Canada? Yes, snus is legal in Canada, provided it complies with the Tobacco and Vaping Products Act and applicable provincial ...The Law On Snus Explained · Canada Restrictions · Future Outlook<|separator|>
[77]
https://www.ordernicotinepouches.com/en-us/pages/nicotine-pouches-legal-by-country
[78]
Snus - Wikipedia
The sale of tobacco-based snus is illegal in several countries, including Australia, New Zealand and all European Union (EU) countries except for Sweden. Non- ...Ettan snus · Health effects of snus · Nicotine pouch · Smokeless tobacco
[79]
Which countries allow the sale of snus?
77 countries currently allow the sale of snus. They are: Afghanistan Albania Algeria Angola Argentina Armenia Bahamas Bangladesh Barbados Belarus Bolivia ...
[80]
Snus - Global State of Tobacco Harm Reduction
In 2017, for the first time, the proportion of the popula-tion using snus – 12 percent – exceeded that of those smoking cigarettes. At 11 percent, Norway now ...
[81]
Snus Market Size, Share Growth And Trends Report, 2030
The global snus market size was estimated at USD 3.01 billion in 2023 and is projected to reach USD 4.10 billion by 2030, growing at a CAGR of 4.7% from 2024 ...
[82]
Snus and snus-like nicotine products moving across Nordic borders
Nicotine pouches, -which are not regarded as medical products in terms of medicine legislation, lack harmonised EU-wide regulation. Controlling smuggling across ...
[83]
Government issues detailed opinion on France's proposal to ban ...
May 22, 2025 · The proposal is far-reaching and involves banning all products containing white snus in France, which would be a restriction of free movement in the EU Single ...Missing: challenges | Show results with:challenges
[84]
Sweden praised for its stand against European restrictions on safer ...
Apr 29, 2025 · The Swedish government has taken unprecedented action to challenge Spain's proposed regulations on tobacco-free nicotine pouches, commonly ...
[85]
Nicotine Pouches at a Crossroads - Tobacco Asia
Jul 15, 2025 · As nicotine pouches continue to grow in popularity, the European Union remains divided on how to tax and regulate them.
[86]
Use of nicotine pouches increases significantly among U.S. teens
Apr 30, 2025 · A team led by Keck School of Medicine of USC researchers found that about twice as many teens used nicotine pouches in 2024 than in 2023.
[87]
Sweden's success in nicotine pouch regulations: lessons for the EU
Feb 28, 2025 · While Sweden has successfully implemented a clear regulatory framework for nicotine pouches, many EU nations continue to grapple with ...
[88]
The story of snus in Sweden and the US - Nordstjernan
By the end of the 1700s, tobacco was grown in as many as 70 Swedish towns. At that time, the Swedes invented the under-the-lip alternative to snuff that is ...
[89]
The history of snus - Snusforumet
Apr 13, 2021 · The first tobacco farms in Sweden sprung up in Skåne, Gränna, and Alingsås, where Jonas Alströmer, known for popularising potatoes in Sweden, ...
[90]
A Short History of Swedish Snus - LinkedIn
Mar 2, 2020 · In early 18th-century Sweden, snus became a moist ground tobacco product originating from a variant of dry nasal snuff. Read this short history ...
[91]
The Swedish snus history
The use of snus was enhanced by the industrial revolution and people moving into the cities. Working on fields, and deciding over one's own breaks, as well as ...<|separator|>
[92]
Swedish Match | Northerner US
1967: The first circular shaped snus container is introduced. This particular type of snus box is still in use today. 1977: The first portion snus, Tre Ankare, ...
[93]
Company history - Swedish Match
Swedish Match's tobacco operations began in 1915, match operations in 1917. The companies merged in 1992 and became Swedish Match in 1994.
[94]
In Sweden, a focus on smokeless tobacco - Roll Call
Apr 10, 2025 · Sweden was granted the sole exception to the European Union's snus ban when it was admitted in 1995. Nicotine pouches are similarly widely ...
[95]
Swedish Match - Tobacco Tactics
Jan 15, 2025 · In February 2009 Swedish Match entered into a joint venture with Philip Morris International (PMI) to “commercialize Swedish snus and other ...
[96]
[PDF] A case study of ZYN's Success in the US Nicotine Pouch Market
Jun 2, 2023 · Swedish Match, a multinational tobacco company based in Sweden. Since its launch in the US in 2016, ZYN has experienced strong sales growth ...
[97]
Cigarette Companies Investing in Snus - Tobacco Tactics
In May 2005 British American Tobacco (BAT) commenced trial markets of snus in South Africa and Sweden, followed by trials in Norway and Canada, plus a “limited ...British American Tobacco · Promotion Of Snus-Type... · Fda Authorises Swedish Match...
[98]
Global Status of Snus - Global State of Tobacco Harm Reduction
... EU countries: » 1992, EU Directive 92/41 banned sales of snus;. » 1995, on accession to the EU, Sweden obtained an exemption;. » 2001, EU Tobacco Products ...
[99]
EU snus ban - SnusDirect.com
It is illegal for any site to sell snus online in EU countries. Till the ban is lifted and EU comes around to Sweden's point of view, the situation is not going ...<|separator|>