For Smoking Cessation, Camel Snus = Nicotine Gum

Camel Snus is equally effective as nicotine gum in helping smokers quit, according to a study funded by the National Cancer Institute (article here).     

Dr. Dorothy Hatsukami and colleagues at the University of Minnesota and the Oregon Research Institute recruited some 400 smokers who wanted to switch to snus or nicotine gum.  They randomized smokers to Camel Snus Winterchill, Robust (~2.5 mg. nicotine per pouch), Frost or Mellow (~1.5 mg), or nicotine gum (2 or 4 mg. nicotine).  Participants received free products for 12 weeks.  Overall, they visited the clinic 10 times over 26 weeks, where they filled out questionnaires and provided blood samples.  They also participated in counseling sessions using the NIH Clearing the Air Quit Smoking program that features conventional quitting tips (“Take a deep breath, clean something, make a move, start a new hobby, splurge on a massage”).  Study participants were paid $360 if they completed the program.

According to the authors, “The results showed no significant differences between those assigned to medicinal nicotine vs snus in amount of product use, levels of cotinine attained, the extent to which the product substituted for smoking and rates of avoidance of cigarettes or any nicotine containing products. Furthermore, there were no differences in suppression of withdrawal from cigarettes.”

In other words, snus was indistinguishable from nicotine gum in helping people avoid cigarettes.  

There was one confusing result.  The authors reported that “nicotine gum users reported more satisfaction and psychological reward from the product.”  However, after 26 weeks 14.9% of the snus group were still using only snus, and 11.6% were using both snus and cigarettes, which was significantly higher than gum users (6.0% and 6.8% respectively). 

This study is not cause for smoking cessation celebration.  Six months after the trial started, only 5.1% of gum users and 2.6% of snus users had continuously quit smoking (the difference was not significant).  The research does, however, demonstrate the fallacy of the claim that snus is unneeded because pharmaceutical nicotine is effective. 

Two years ago, I discussed a clinical trial showing that e-cigarettes were about as effective as nicotine patches in helping smokers quit (here). Now we have evidence that snus is just as effective as nicotine gum, even though success rates for both were abysmal.  The real take-away is that smokers should have access to all cigarette substitutes.