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Alternative Product Harm Perception

Researchers look at how consumers view reduced harm nicotine products and how that impacts their willingness to switch as America sees honest snus claims mailed to households

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A University of Pennsylvania team has looked at the perceptions of harm and beliefs about alternative reduced risk nicotine products. Adults were recruited online to express their opinions about vape products, snus, and heated tobacco devices. The paper was published as an example of an American snus education mailshot came to light, showing the country has actually got something correct when it comes to harm reduction.

While the choice of categorisation is unfortunate, the authors of the paper(1) do acknowledge, “There is a growing recognition among tobacco control experts that tobacco products pose different levels of risk which exist along a ‘continuum of risk’. Snus (a low nitrosamine type of moist snuff), and e-cigarettes pose significantly fewer health risks to individual users compared to cigarettes.”

They also note what has been widely observed, that “users’ perceptions about the comparative risks of tobacco products are often inconsistent with the continuum of risk.” Many have pointed to media coverage for hardening false opinions in smokers and the general public.

They found:

  • E-cigarettes were the most well-known product of the three potentially modified risk tobacco products
  • 97% of participants had heard of vaping
  • Only 12.5% of the participants had heard of heated tobacco
  • 54% of participants had ever used at least one of the products
  • The overwhelming majority of current users vaped

On the downside, the authors write: “The three most endorsed beliefs about using e-cigarettes were that they contained nicotine, they were risky, and that they caused lung damage. Participants were least likely to endorse the beliefs that e-cigarettes had long-term health benefits, that they were cool, and that there were not addictive.

Participants most commonly endorsed the belief that e-cigarettes appealed to kids, that the science about e-cigarettes could not be trusted, and that e-cigarettes were expensive.”

Similarly, respondents didn’t believe that the science about snus was trustworthy or that snus helps tobacco smokers quit.

The Truth About Snus

Fortunately, the American Food and Drug Administration (FDA) authorised health claims about snus in 2019(2) which may go some way to combatting the misconceptions the researchers discovered.

Meanwhile, the state of play for snus remains corrupted in the European Union. When the FDA made its announcement, Mark Oates spoke out(3) on behalf of the New Nicotine Alliance: “It is inexplicable why the EU continues to perpetuate the ban on European smokers choosing to switch to snus. Not only is the sale of snus permitted in the USA, but they have now allowed one company to make the undisputed claim that “using snus instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis”, the difference in approach could not be more stark, and it is the EU which is being reckless with its public’s health, not America.”

As we enter a period where Brexit opens up new opportunities(4) to further reduce the toll of tobacco relate disease and death, it is time to reappraise our position on snus and allow sensible messages in line with America’s.


  1. Harm Perceptions and Beliefs about Potential Modified Risk Tobacco Products -
  2. FDA Authorizes Modified Risk Tobacco Products -
  3. United States acknowledges reduced risk of snus, the EU should follow suit -
  4. Post-Brexit Opportunities -

Photo Credit:

Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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