Awareness and use of oral tobacco and nicotine products among people who smoke or recently stopped smoking: Descriptive findings from the 2024 EASE/ITC New Zealand Survey

INTRODUCTION: Aotearoa New Zealand (NZ) disallows sales of oral tobacco and nicotine products, although importation for personal use is permitted. The government proposes legalising sales, claiming this will aid smoking cessation among "older, long-term smokers." We examined awareness and use of tobacco-free oral nicotine products (ONPs), snus, and other oral tobacco products among adults who smoke or who recently stopped smoking. METHODS: We analysed Wave 5 (2024) data from the EASE/International Tobacco Control (ITC) NZ Survey (N=1,371) of adults who smoke or recently stopped smoking. We examined prevalence of awareness, ever, and current (at least monthly) use of oral tobacco and nicotine products, overall and by demographic factors and smoking status/cessation intentions. RESULTS: Awareness was 41.3% (95% confidence interval 37.7, 45.0) for ONPs, 31.5% (28.1, 35.2) for snus, and 70.2% (66.6, 73.5) for other oral tobacco products. Ever use was 12.5% (10.5, 14.8), 7.0% (5.5, 8.8), and 11.6% (9.6, 14.0) respectively. Current use was 4.1% (3.1, 5.6), 2.4% (1.5, 3.6), and 2.6% (1.9, 3.7) respectively. Weighted point estimates for awareness and use of snus and any oral product overall were lower among adults aged ≥45 than those aged 18-24 or 25-44. Current use of oral products was 5.8% (3.3, 10.1) among those who smoked daily with no intention to stop. CONCLUSIONS: Current policy settings allow meaningful levels of oral product use in NZ. Use is uncommon among adults aged ≥45 years and occurs among people without cessation intentions, highlighting the risk that use may complement rather than replace smoking.