Association Between Willingness to Use Snus to Quit Smoking and Perception of Relative Risk Between Snus and Cigarettes

INTRODUCTION: Smokers are often incorrect in their assessment of the relative risk of snus and cigarettes. We have studied how perception of risks of snus compared with cigarettes was associated with the willingness of trying snus as a quit-smoking method. METHODS: Fourteen thousand seven hundred and forty-four Norwegian men aged 20–50 years were selected at random from a national representative web panel and sent a questionnaire by e-mail. Of the 7,170 (48.6%) who responded, there were 1,155 former daily smokers who reported method for quitting smoking and 1,213 current daily smokers who stated their willingness to try different methods for quitting smoking. They were also asked to assess the relative risk between daily use of snus and cigarettes. RESULTS: Adjusted odds ratio (AOR) for reporting willingness to try snus in future quit attempts was significantly higher (AOR = 4.82, p < .001) for the 22.9% of the current smokers who, consistent with scientific evidence, believed that the health risks were “far lower” for snus than for cigarettes compared with the 39.8% who incorrectly perceived the health risks to be “equal or higher” for snus (reference AOR = 1). About 37.2% of the daily smokers believed that the risk was “somewhat lower” for snus than for cigarettes and had a significantly higher AOR of reporting willingness to try snus (AOR = 2.31, p < .001) compared with the reference group. CONCLUSION: Devising a way to inform smokers about the risk continuum of tobacco products could be an important research priority in countries where snus is allowed to compete with cigarettes for market share.