The truth about Snus, the trendy nicotine pouches loved by footballers (2024)

They may be super fit, health-conscious athletes put on strict diets. But professional footballers - such as Manchester United’s Victor Lindelof and Leicester City’s Jamie Vardy - have developed a penchant for a new class of nicotine product - called snus.

In fact almost one in five male professional players in the UK is now taking nicotine orally – either in tobacco-free nicotine pouches or Swedish-style snus (which is illegal to sell in this country), which look similar but contain tobacco – according to a study published this week by Loughborough University, commissioned by the Professional Footballers' Association.

Both types of products come in small teabag-like sachets. These are placed under the lip, for between five minutes and an hour, to release nicotine through the gum into the bloodstream.

Not only are both types highly addictive and may harm oral health (see box), but in particular tobacco-containing snus is considered risky and is banned throughout UK and the EU. Even in Sweden where youcan buy snus, there have been warnings about a potentially raised risk of cancer and death from heart disease.

Most of the 679 male and female footballers surveyed said they used tobacco-free nicotine pouches rather than snus, but whatever their choice of product, nearly half the footballers in the new survey said they wanted to kick the habit.

What are nicotine pouches?

These oral pouches are tobacco-free nicotine products and are available to buy legally in the UK.

Swedish snus pouches are filled with tobacco powder. They look and feel similar to the nicotine pouches, like very small teabags. Selling snus is illegal in the UK because of the powdered tobacco.

All oral tobacco products have been banned here since 1992 over fears that they can cause cancers and heart disease.

However, internet vendors are offering tobacco-containing snus to UK customers online, and it is not against the law for individuals to use them.

The tobacco-free versions, known as nicotine pouches, started being sold in the UK five years ago. Often they contain flavourings such as fruit, mint and coffee that are considered harm-free.

There is no age limit on who can buy them in the UK, and the makers can even hand out free samples to anyone.

What's the appeal?

The attraction of snus and nicotine patches is the 'hit' users get from nicotine, without smoking cigarettes.

Numerous studies show that nicotine causes the brain to release dopamine, a 'feel-good' chemical that gives an addictive sense of relaxation and reward.

In the Loughborough University survey, football club staff said players used nicotine pouches to help 'unwind' from the adrenaline of a game.

They also thought the nicotine might help them to focus mentally, and to reduce their appetite.

Stopping the nicotine produces withdrawal symptoms of agitation and upset.

In the Loughborough study, more than half the male footballers and almost three-quarters of the women reported nicotine dependency from the pouches. A similar proportion said they wanted to kick the habit.

The most common withdrawal symptoms complained about by both sexes were cravings, irritableness and restlessness.

Pouches are becoming more popular in the UK

Last year there were more than half a million tobacco-free nicotine-pouch users in the UK, according to the cigarette-giant, British American Tobacco UK (BAT).

Yet the figure was around zero only five years ago, when these nicotine pouches first became available in the UK.

BAT forecasts that there may be more than two million regular nicotine-pouch users in the UK by 2026.

That number will continue to grow rapidly – at around 40 per cent a year from 2024 to 2030, according to the analysts Grand View Research.

Commentators predict that the proposed UK ban on disposable vapes in the Tobacco and Vapes Bill – which is backed by both Labour and the Conservatives and set to be introduced next year – may drive spiralling numbers of people to nicotine pouches. Commercial bans on indoor vaping may also have the same effect.

There are no statistics on tobacco-containing snus sales, as the trade is illegal.

Cheap and easier to get hold of than vapes

Nicotine pouches are entirely legal and readily available across the UK for a relatively small cost of around £6 for a container of 20 pouches.

Nicotine pouches are currently marketed as consumer products in the UK rather than as medical devices (which is how vapes are categorised).

Therefore, unlike vapes, nicotine pouches do not fall under the jurisdiction of the UK drug safety watchdog, the Medicines and Healthcare Products Regulatory Agency.

So unlike vapes, nicotine pouches are not subject to any medical rules about their contents, their sale or use.

Why experts are concerned

A report in the British Dental Journal in 2021 warned that nicotine pouches may introduce a 'gateway effect attractive to young people', which would provide a stepping stone to cigarette smoking 'due to the combination of addictive nicotine, pleasant flavours and attractive packaging'.

The anti-tobacco campaigning group Action on Smoking and Health (ASH) warns that there are currently no restrictions to selling the pouches to children, or on the advertising or promotion of nicotine pouches. Nor is there any limit on the strength of the addictive nicotine they contain.

Deborah Arnott, chief executive of ASH, told Mail+: 'We are definitely concerned about the lack of regulation of nicotine pouches. It's one of the many reasons we want the Tobacco and Vapes Bill to come back as soon as possible after the election, as it would give government powers to regulate these products properly.'

Are they as risky as smoking?

Tobacco-containing snus is considered high risk and is banned in the UK and the EU, with the exception of Sweden.

Even there, in 2010 Sweden's National Institute of Public Health drew attention to research showing that using snus is statistically associated with a raised risk of cancer and death from heart disease.

Then in 2022, researchers at the Karolinska Institute in Stockholm warned in the journal PloS One that habitually using tobacco-containing snus can make arteries much stiffer, reducing blood flow and potentially increasing the chances of heart disease.

Tobacco-free nicotine pouches are reportedly much safer than snus or smoking.

Chemical analysis shows that these pouches contain far fewer toxic compounds than both Swedish snus and tobacco smoking, the journal Drug and Chemical Toxicology reported in 2022.

Indeed, pure nicotine is not classed as a carcinogen and has been used for decades in the nicotine-replacement therapy skin patches used by NHS stop-smoking services.

However Dr Praveen Sharma, scientific adviser to the British Dental Association and a specialist in restorative dentistry at Birmingham Dental Hospital, told Mail+: 'In the long term, we still don't know what the body-wide health effects are of using nicotine pouches. This is because we don't have any long-term study data on their impact on overall health.'

Praveen Sharma adds: 'Our advice to patients is that, if they are a smoker who's using tobacco-free nicotine pouches to stop smoking, that's OK because it's less risky than smoking.

'But if they are a non-smoker they shouldn't use them because there may be potential risks.'

How do they affect your oral health?

'There are definitely concerns about the impact of nicotine pouches on gum health,' says Praveen Sharma.

'In patients using pouches we often see gum recession where the pouch is habitually placed and damages the gum tissue, which can cause tooth loss.'

Similarly, Joshua Jackson, a clinical fellow at the Newcastle University School of Dental Sciences, warned in the British Dental Journal last year that, 'there may be some localised effects on plaque accumulation on the tooth surfaces near where the pouch is held, leading to increased decay risk'.