REDUCTION IN NICOTINE INTAKE AND ORAL MUCOSAL CHANGES AMONG USERS OF SWEDISH ORAL MOIST SNUFF AFTER SWITCHING TO A LOW-NICOTINE PRODUCT

The purpose of this investigation was to assess nicotine regulation am ong users of portion-bag Swedish oral moist snuff (snus) when switchin g from an ordinary snus product (Brand A) to a low-nicotine product ha ving only half the concentration of nicotine (Brand B). Two studies we re performed to compare the shortterm effects on consumption and nicot ine intake of switching to low-nicotine snus with those of long-term e ffects. In Study 1, consumption data. soft tissue changes and nicotine intake were measured in a group of 24 habitual users of Swedish porti on-bag snus, both during use of their ordinary snus (Brand A) for 2 we eks and during consumption of the low-nicotine product (Brand B) for 1 0 weeks. In study 2, the same data were measured during 1 weeks in a r eference group of 18 snus users who had been habitual users of the low -nicotine snus (Brand B) for at least one year. Although there was no increase in number of hours of daily consumption, the amount of snus c onsumed increased on average by 2 grams a day (+15%) when switching fr om Brand A to the low-nicotine Brand B (Study 1). The Brand B referenc e group (Study 2) consumed about 3 grams less snus a day during the sa me number of hours as the subjects in Study 1 who had switched to Bran d B. These results indicate that snus users compensate to a small exte nt for the lower nicotine delivery by increasing their consumption on short-term switching but the same does not apply to long-term users. T here was a significant reduction in nicotine intake when switching to the low-nicotine brand. The individual average saliva cotinine levels decreased from 336 ng/ml to 153 ng/ml and total amounts of nicotine eq uivalents excreted during 24 h decreased from 25.2 mg to 14.4 mg (Stud y 1), reaching about the same levels found in the reference group in S tudy 2(159 ng/ml and 14.3 mg, respectively). After switching from Bran d A to Brand B in Study 1, there was a decrease in the frequency of De gree 3 clinical lesions and an increase in Degree 2 lesions. Also, Deg ree 3 lesions were less frequent, and Degree 1 lesions more frequent, in Study 2 than in Study 1. These observations point to the developmen t of less pronounced changes after both long-term and short-term switc hing to a low-nicotine snus.