Smokers perceptions of smokeless tobacco and harm reduction

Mojgan Sami, David S. Timberlake*, Russ Nelson, Brittany Goettsch, Naeem Ataian, Penney Libao, Elanora Vassile

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Existing survey data indicate that most smokers are not receptive to harm reduction incentives of switching to smokeless tobacco (SLT). Little is known about the underlying reasons for these views. To explore smokers perceptions of SLT, we conducted a focus group (eight in total) study of daily smokers between 2009 and 2010 at the University of California, Irvine. We transcribed each 2-hour focus group verbatim and analyzed it using domain analysis. The discussions revealed several reasons why smokers are not receptive to SLT. First, smokers associated new spit-less SLT (that is, Snus) with historic images of chewing tobacco. Second, smokers viewed smoking as an incentive to take a break from their daily routine. Third, smokers expressed lack of control over nicotine delivery when using SLT, relative to cigarettes. These findings challenge tobacco manufacturers strategies to market a smokeless alternative as a growing number of smoke-free policies are introduced.

Original languageEnglish (US)
Pages (from-to)188-201
Number of pages14
JournalJournal of Public Health Policy
Issue number2
StatePublished - May 2012


  • Harm reduction
  • Qualitative domain analysis
  • Smokeless tobacco
  • Tobacco control

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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