Characteristics of users of oral nicotine products according to smoking status in Denmark

Abstract Background Oral nicotine products e.g., snus, chewing tobacco, and tobacco-free nicotine pouches gain increasing popularity. The aim of the study was to estimate the prevalence of use of oral nicotine products in the Capital Region of Denmark in 2021, to describe associations with socio-demographic characteristics and to explore if smoking status moderated these associations. Methods The study was based on the Danish Capital Region Health Survey 2021 including 56,245 persons aged ≥16 years old (response rate 54.9%) which included self-reported information on use of oral nicotine products and smoking status. Information on socio-demographic characteristics were assessed in national registries. Descriptive analyses and multivariate logistic regression models including interaction terms with smoking status and weighted for survey-sampling and non-response were performed. Results In total, 3.5% used oral nicotine products. Men showed higher odds of using oral nicotine products compared with woman (OR = 3.70) while there were no associations with education and occupational affiliation when adjusted for sex and age. The associations with age and place of residence were moderated by smoking status. Among smoking participants, young persons aged 16-19 years showed the strongest association with use of oral nicotine products (sex-adjusted OR = 21.71) while persons aged 20-24 years showed the strongest association in non-smoking participants (OR = 11.08). Conclusions Especially men and young age were strongly associated with use of oral nicotine products. For age, the association was moderated by smoking status. Interventions should address these high-risk groups and pay attention to smoking status. Key messages • Sex and age play a siginificant role in use of oral nicotine products. • Interventions and public health campagins should adress high-risk groups