{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:28:38Z","timestamp":1788211718755,"version":"build-2803163510"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Around 50 percent of the tobacco in Norway is consumed in the form of snus, a smokeless oral tobacco. We examined Norwegian smokers\u2019 openness, and thereby the potential reach, to use e-cigarettes, nicotine replacement therapy products (NRT), and snus in the event of quitting smoking, in a society where snus use is common.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using data from an online survey of 4073 smokers from 2019 to 2021, we calculated predicted probabilities of smokers\u2019 being open, undecided, and not open to use e-cigarettes, snus, and NRT in the event they should quit smoking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among daily smokers, the probability of being open to use e-cigarettes in the event of quitting smoking was .32. The corresponding probabilities for using snus and NRT were .22 and .19. Snus was the product with the highest probability of not being open (.60). NRT had the highest probability of being undecided (.39). Among smokers who had never used e-cigarettes or snus, the probabilities of being open were .13 for e-cigarettes, .02 for snus and .11 for NRT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a snus-friendly norm climate where smokers have traditionally used snus as an alternative to cigarettes, the probability of using e-cigarettes in the event of smoking cessation was higher compared to both snus and NRT. However, among smokers who had never used e-cigarettes or snus, the likelihood of being open to use of NRT was similar to e-cigarettes, and higher than snus, which suggests that NRT may still play a role in smoking cessation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>In a snus-prevalent country in the endgame phase of the cigarette epidemic, where robust infrastructure for tobacco control in combination with the availability of snus has reduced smoking to a minimum, the remaining smokers seem to prefer e-cigarettes to snus if they should quit smoking. This indicates that availability of several nicotine alternatives might increase the likelihood of a future product replacement within the small group of remaining smokers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad113","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T19:28:39Z","timestamp":1688671719000},"page":"1753-1761","source":"Crossref","is-referenced-by-count":4,"title":["How do Smokers in a Snus-Prevalent Society Consider E-cigarettes, Snus, and Nicotine Replacement Therapy Products as Relevant Replacements for Cigarettes in the Event They Should Stop Smoking?"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9603-8940","authenticated-orcid":false,"given":"Tord Finne","family":"Ved\u00f8y","sequence":"first","affiliation":[{"name":"Department Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health , Oslo , Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4015-1167","authenticated-orcid":false,"given":"Karl Erik","family":"Lund","sequence":"additional","affiliation":[{"name":"Department Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health , Oslo , Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"2023090404200601300_CIT0001","author":"Lund"},{"key":"2023090404200601300_CIT0002","author":"Ved\u00f8y"},{"key":"2023090404200601300_CIT0003","author":"Ved\u00f8y"},{"key":"2023090404200601300_CIT0004","author":"Ved\u00f8y"},{"key":"2023090404200601300_CIT0005","author":"Lund"},{"issue":"3","key":"2023090404200601300_CIT0006","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1093\/ntr\/nts185","article-title":"Patterns of dual use of snus and cigarettes in a mature snus market","volume":"15","author":"Lund","year":"2013","journal-title":"Nicotine Tob Res."},{"issue":"6","key":"2023090404200601300_CIT0007","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1177\/14550725211021248","article-title":"A conceptual framework for assessing the public health effects from snus and novel non-combustible nicotine products","volume":"38","author":"Lund","year":"2021","journal-title":"Nord. Stud. Alcohol Drugs"},{"issue":"3","key":"2023090404200601300_CIT0008","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1136\/tc.2005.014969","article-title":"Role of snus in initiation and cessation of tobacco smoking in Sweden","volume":"15","author":"Ramstr\u00f6m","year":"2006","journal-title":"Tob Control."},{"issue":"11","key":"2023090404200601300_CIT0009","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.3390\/ijerph13111110","article-title":"Patterns of smoking and snus use in sweden: implications for public health","volume":"13","author":"Ramstr\u00f6m","year":"2016","journal-title":"Int J Environ Res Public Health."},{"issue":"2","key":"2023090404200601300_CIT0010","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/add.13638","article-title":"Do never smokers make up an increasing share of snus users as cigarette smoking declines? Changes in smoking status among male snus users in Norway 2003-2015","volume":"112","author":"Lund","year":"2016","journal-title":"Addiction."},{"issue":"7","key":"2023090404200601300_CIT0011","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1093\/ntr\/ntac006","article-title":"Nicotine content in swedish-type snus sold in norway from 2005 to 2020","volume":"24","author":"Ved\u00f8y","year":"2022","journal-title":"Nicotine Tob Res."},{"issue":"12","key":"2023090404200601300_CIT0012","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1093\/ntr\/ntu109","article-title":"Contrasting smokers\u2019 and snus users\u2019 perceptions of personal tobacco behavior in norway","volume":"16","author":"Lund","year":"2014","journal-title":"Nicotine Tob Res."},{"issue":"4","key":"2023090404200601300_CIT0013","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1136\/tobaccocontrol-2013-051342","article-title":"Snus use and rejection in the USA","volume":"25","author":"Biener","year":"2014","journal-title":"Tob Control."},{"issue":"4","key":"2023090404200601300_CIT0014","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1136\/tc.2009.030221","article-title":"Snus does not save lives: quitting smoking does!","volume":"18","author":"Holm","year":"2009","journal-title":"Tob Control."},{"key":"2023090404200601300_CIT0015","volume-title":"The Tobacco Control Act","author":"The Norwegian Ministry of Health and Care Services","year":"2020"},{"issue":"2","key":"2023090404200601300_CIT0016","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1093\/ntr\/ntab171","article-title":"Newspaper coverage of snus in an emerging norwegian snus market 2002-2011: a content analysis","volume":"24","author":"S\u00e6b\u00f8","year":"2022","journal-title":"Nicotine Tob Res."},{"key":"2023090404200601300_CIT0017","author":"Norwegian Institute of Public Health","year":"2019"},{"key":"2023090404200601300_CIT0018","author":"Norwegian Institute of Public Health","year":"2014"},{"issue":"5","key":"2023090404200601300_CIT0019","doi-asserted-by":"crossref","first-page":"879","DOI":"10.3390\/ijerph16050879","article-title":"Relative risk perceptions between snus and cigarettes in a snus-prevalent society\u2014an observational study over a 16 year period","volume":"16","author":"Lund","year":"2019","journal-title":"Int J Environ Res Public Health."},{"key":"2023090404200601300_CIT0020","author":"Royal College of Physicians","year":"2007"},{"issue":"5","key":"2023090404200601300_CIT0021","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1159\/000360220","article-title":"Estimating the harms of nicotine-containing products using the MCDA approach","volume":"20","author":"Nutt","year":"2014","journal-title":"Eur Addict Res."},{"issue":"12","key":"2023090404200601300_CIT0022","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1158\/1055-9965.2035.13.12","article-title":"The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts","volume":"13","author":"Levy","year":"2004","journal-title":"Cancer Epidemiol Biomarkers Prev."},{"issue":"11","key":"2023090404200601300_CIT0023","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.2105\/AJPH.2005.075499","article-title":"Public health implications of smokeless tobacco use as a harm reduction strategy","volume":"96","author":"Savitz","year":"2006","journal-title":"Am J Public Health."},{"issue":"9","key":"2023090404200601300_CIT0024","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1093\/ntr\/nty074","article-title":"Association of smokeless tobacco use and oral cancer: a systematic global review and meta-analysis","volume":"21","author":"Asthana","year":"2019","journal-title":"Nicotine Tob Res."},{"issue":"2","key":"2023090404200601300_CIT0025","doi-asserted-by":"crossref","first-page":"e000846","DOI":"10.1136\/openhrt-2018-000846","article-title":"Smokeless tobacco use and circulatory disease risk: a systematic review and meta-analysis","volume":"5","author":"Rostron","year":"2018","journal-title":"Open Heart"},{"key":"2023090404200601300_CIT0026","volume-title":"WHO Study Group on Tobacco Product Regulation. Report on the scientific basis of tobacco product regulation: third report of a WHO Study Group","author":"WHO Study Group on Tobacco Production Regulation","year":"2009"},{"issue":"4","key":"2023090404200601300_CIT0027","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1136\/tc.12.4.349","article-title":"Effect of smokeless tobacco (snus) on smoking and public health in Sweden","volume":"12","author":"Foulds","year":"2003","journal-title":"Tob Control."},{"issue":"19","key":"2023090404200601300_CIT0028","article-title":"A fresh look at tobacco harm reduction: the case for the electronic cigarette","volume":"10","author":"Polosa","year":"2013","journal-title":"Harm Reduct J"},{"issue":"16","key":"2023090404200601300_CIT0029","first-page":"1185","article-title":"Self-reported sources for distribution of cigarettes, snus and e-cigarettes [in Norwegian]","volume":"137","author":"Ved\u00f8y","year":"2017","journal-title":"Tidsskr Nor Laegeforen."},{"issue":"3","key":"2023090404200601300_CIT0030","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/dar.12907","article-title":"Barriers and facilitators to switching from smoking to vaping: advice from vapers","volume":"38","author":"Morphett","year":"2019","journal-title":"Drug Alcohol Rev."},{"key":"2023090404200601300_CIT0031","article-title":"Norwegian association for pulmonary medicine warns about e-cigarettes [In Norwegian]","author":"Baugst\u00f8","year":"2020","journal-title":"Tidsskr Nor Laegeforen."},{"issue":"5","key":"2023090404200601300_CIT0032","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1111\/1467-9566.12854","article-title":"\u201cCloud chasers\u201d and \u201csubstitutes\u201d: e-cigarettes, vaping subcultures and vaper identities","volume":"41","author":"Tokle","year":"2019","journal-title":"Sociol Health Illn."},{"issue":"e1","key":"2023090404200601300_CIT0033","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1136\/tobaccocontrol-2014-052151","article-title":"Smokers\u2019 and ex-smokers\u2019 understanding of electronic cigarettes: a qualitative study","volume":"25","author":"Rooke","year":"2016","journal-title":"Tob Control."},{"issue":"1","key":"2023090404200601300_CIT0034","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1940-0640-8-5","article-title":"Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach","volume":"8","author":"Barbeau","year":"2013","journal-title":"Addict Sci Clin Pract"},{"issue":"6","key":"2023090404200601300_CIT0035","doi-asserted-by":"crossref","first-page":"928","DOI":"10.2967\/jnumed.119.230748","article-title":"Rapid brain nicotine uptake from electronic cigarettes","volume":"61","author":"Solingapuram Sai","year":"2020","journal-title":"J Nucl Med."},{"key":"2023090404200601300_CIT0036","doi-asserted-by":"crossref","first-page":"103559","DOI":"10.1016\/j.drugpo.2021.103559","article-title":"Public support for further regulating smoking, snus and e-cigarettes in Norway, and its associations with risk perceptions and tobacco use","volume":"101","author":"Saebo","year":"2022","journal-title":"Int J Drug Policy."},{"issue":"3","key":"2023090404200601300_CIT0037","first-page":"425","article-title":"Nicotine replacement therapy: an overview","volume":"10","author":"Wadgave","year":"2016","journal-title":"Int J Health Sci (Qassim)"},{"key":"2023090404200601300_CIT0038","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/add.14006","article-title":"Estimates of effectiveness and reach for \u201creturn on investment\u201d modelling of smoking cessation interventions using data from England","volume":"113","author":"West","year":"2018","journal-title":"Addiction."},{"issue":"5","key":"2023090404200601300_CIT0039","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1177\/14550725221096911","article-title":"The impact of covid-19 epidemic on where tobacco users purchased cigarettes and snus in different norwegian regions","volume":"39","author":"Ved\u00f8y","year":"2022","journal-title":"Nord. 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