Most of America’s 45 million smokers have never considered switching to a smokeless tobacco product.  They have plenty of options, but we have little information about smokers’ product preferences.

A new study gauges smokers’ perceptions of five smokeless products: General Snus from Swedish Match, Camel Snus from Reynolds, Marlboro Snus from Phillip Morris, and Stonewall and Ariva dissolvable pellets (which are no longer marketed) from Star Tobacco.

The study, appearing in Nicotine & Tobacco Research, was authored by Dorothy Hatsukami, a tobacco researcher from the University of Minnesota and former member of the FDA Tobacco Products Scientific Advisory Committee, and colleagues from Roswell Park Cancer Institute and the Oregon Research Institute.

Dr. Hatsukami recruited 97 smokers interested in quitting. After not smoking for five hours, the subjects sampled each of the five products on separate days over a two-week period (brand names were hidden). They then answered 21 questions about satisfaction, psychological reward, aversion (dizziness, nausea, other bothersome side effects), relief of craving/withdrawal, ease of use, comfort and dependence concerns. Answers were based on a Likert scale ranging from 1 (not at all) to 7 (extremely); 4 is neutral. At the end of the sampling period they were asked to pick a product to use during two weeks of smoking abstinence.

Average Smokers’ Scores For Smokeless Tobacco Products During Sampling Period
Product (Nicotine Content, mg) Satisfaction Psychological Reward Aversion Relief Ease of Use Comfort Dependence Concern
General Snus (3.4) 1.8 2.2 2.7 3.4 4.8 3.9 1.5
Camel Snus (1.8-2.0) 3.6 2.6 1.9 3.8 5.7 4.9 2.0
Marlboro Snus (0.1-0.4) 3.6 2.5 1.7 3.7 5.5 4.8 1.9
Stonewall (0.3-0.6) 3.3 2.4 1.9 3.6 5.8 5.6 1.8
Ariva (0.2) 3.4 2.4 1.6 3.5 5.9 5.4 1.8

Average scores for the products are seen in the table. Camel and Marlboro snus had the highest scores for satisfaction and relief of craving/withdrawal, even though they had vastly different levels of free nicotine, the form that is readily absorbed in the mouth. The dissolvable products scored highest for ease of use and comfort.

Smokers’ individual product scores were correlated with their preferred product for the smoke-free period. Camel snus was picked by the largest percentage (28%), followed closely by Stonewall and Ariva (24% each), and Marlboro snus (23%). No one picked General Snus, probably because of its high nicotine content, which accounted for higher aversion scores.

The research leaves a few questions unanswered. Information on cigarette and smokeless consumption during the smoke-free period was collected, but not reported. Two-thirds of the subjects in this study were female, but the authors did not comment on the effect of gender on the scores. Women have considerably different perceptions of smokeless tobacco than men.

These shortcomings aside, the Hatsukami study provides valuable data on smokers’ preferences for various smoke-free products.

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