Gender differences in snus versus nicotine gum for cigarette avoidance among a sample of US smokers

Alicia Allen, Rachel Isaksson Vogel, Ellen Meier, Amanda Anderson, Joni Jensen, Herbert H. Severson, Dorothy Hatsukami

Research output: Contribution to journalArticlepeer-review


Introduction Women are more susceptible to the harmful effects of cigarette smoking. Thus, identifying effective harm reduction approaches for women is necessary. The goal of this project was to examine gender differences in response to snus versus nicotine gum for cigarette avoidance, as a means of harm reduction. Methods Participants were randomly assigned to use snus or nicotine gum as a method to avoid cigarette smoking. Participants attended clinic visits to receive study product, as well as provide biological samples to assess smoking avoidance and biomarkers and report on use of study product and cigarettes. A secondary analysis comparing men and women by randomization to study product was conducted. Results Participants (n = 391; 47% women) were randomized into the snus group (n = 196; 45% women) and the gum group (n = 195; 49% women). Men used more snus whereas women used more gum (p = 0.02). During treatment, men in the snus group had higher total nicotine equivalent values whereas women did not vary by group (p = 0.03). Overall, fewer men in the snus group completely avoided cigarettes compared to men in the gum group (e.g., continuous abstinence at Week 12: odds ratio = 0.43, 95% confidence interval = 0.20–0.93). Among women, there were no differences by randomization in cigarette avoidance. Conclusions Despite a number of gender differences in response to snus versus nicotine gum, these data suggest that snus may not be an optimal harm reduction approach for either gender.

Original languageEnglish (US)
Pages (from-to)8-12
Number of pages5
JournalDrug and alcohol dependence
StatePublished - Nov 1 2016

Bibliographical note

Funding Information:
Funding was provided by R01CA135884 , U19CA157345 (D. Hatsukami), P30CA077598 , UL1TR000114 , and the Building Interdisciplinary Research Careers in Women’s Health Grant ( K12HD055887 ) from the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD) , the Office of Research on Women’s Health , and the National Institute on Aging , NIH , administered by the University of Minnesota Deborah E. Powell Center for Women’s Health. The content is solely the responsibility of the authors and does not necessarily represent the office views of the NICHD or NIH. These funding sources had no role in the study design, collection, analysis or interpretation of data, writing the manuscript or the decision to submit the paper for publication.

Publisher Copyright:
© 2016 Elsevier Ireland Ltd


  • Cigarette smoking
  • Gender differences
  • Harm reduction
  • Nicotine replacement
  • Snus


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