Assessing quit interest and the correlates and preferred ways of quitting snus in Norway: A cross-sectional study.

Introduction: Snus is currently the most used tobacco product in Norway. This study aims to identify the overall cessation interest among Norwegian snus users, the preferred quitting aids, and correlates of cessation interest.

Methods: Survey data were collected by the Norwegian Directorate of Health through a nationwide web panel, with respondents completing an online questionnaire. Three time points (two in 2018, one in 2019) were pooled, resulting in n=820 snus users. Descriptive statistics and adjusted multinomial logistic regression were applied to identify the extent of snus cessation behavior and factors associated with overall cessation interest.

Results: In all, 58.5% had attempted to quit snus, while 52.7% expressed current plans to quit. Of all snus users, 26.6% had never tried to quit and did not intend to quit in the future; 35.7% had either previously tried to quit but held no current quit plans, or they had never attempted to quit but were willing to try in the future. The remaining 37.7% had both tried to quit and intended to try again. Frequently preferred quitting aids were: quit on my own, mobile app, and nicotine-free snus. Higher interest in quitting was associated with younger age (AOR=0.94, p<0.001), living in western (AOR=2.27, p=0.019) or northern (AOR=2.60, p=0.022) Norway, perceiving snus use as hazardous to health (AOR=2.37, p<0.001), using snus daily (AOR=2.83, p<0.001), and non-smoking (AOR=0.53, p=0.033). Cessation behavior was not statistically associated with education level or income, after controlling for covariates.

Conclusions: The majority of snus users are interested in quitting, especially those who are young and worry about their own health. We found no evidence of a social gradient in cessation interest.