Pharmacokinetics and pharmacodynamics of moist snuff in humans

Objective - To examine the effects of four brands of commercially available moist snuff and non-tobacco mint "snuff" on plasma nicotine concentration, heart rate, blood pressure, and subjective measures. Intervention - Four brands of moist snuff and a non-tobacco mint snuff were tested. Subjects reported to the laboratory for five experimental sessions. After baseline measurement of dependent variables, each subject placed 2 g of one of the brands of snuff (or one Skoal Bandits pouch) between the cheek and gum for 30 minutes. The subjects remained in the experimental laboratory for an additional 60 minutes. Subjects - Ten volunteers who were daily users of smokeless tobacco. Main outcome measures - Plasma nicotine concentration, cardiovascular effects, and subjective effects. Results - Large amounts of nicotine were delivered rapidly to the bloodstream. The amount of nicotine absorbed and the rate of absorption were related to the pH of the snuff product in aqueous suspension. Cardiovascular and subjective effects were related to the amount of nicotine absorbed. Conclusions - Snuff products are capable of rapidly delivering high doses of nicotine, which can lead to dependence. Long-term use of snuff can lead to a number of adverse health effects including oral cancers, cardiovascular diseases, and gingival diseases. For these reasons, it is important that the public health community considers oral snuff use as a burden on public health in the same way that cigarette smoking is recognised.