Snus use is rife in football—but at what cost? While it’s generally accepted that snus use is lower risk than smoking cigarettes, its use is unlikely to be harm free.
Introduction
I first came across snus back in secondary school, when one of the lads in my year had brought some back from the UK (where he was playing for a Premier League academy team). I tried it once but didn’t like it. However, I didn’t really have access to it again after that time, so it’s possible that I didn’t have enough exposure to acquire the taste for it.
In football—where snus use is culturally ingrained and players are constantly exposed to it—it seems that more and more players are acquiring the taste for it. In fact, a recent study from researchers at Loughborough University reported that one in five male and female professional football players in Premier League and EFL clubs are using snus or nicotine pouches, with about a quarter of those using 11+ pouches in a typical day (1).
With such high usage in football, it’s essential for all who are involved in the game to know the health risks of snus and nicotine pouch use so that players can make informed decisions about whether to use it or not.
Snus pouches.
What is Snus?
Snus and nicotine pouches are smokeless tobacco products used by placing them under the lip. Snus is a moist powder made from tobacco, commonly used in Sweden, while nicotine pouches are similar but don't contain tobacco—just nicotine and other ingredients. Both deliver nicotine to the body without smoking, making them popular alternatives to cigarettes.
When placed under the lip, snus and nicotine pouches release nicotine through the lining of the mouth, providing a quick and steady absorption into the bloodstream. Unlike smoking, which delivers nicotine via inhalation and impacts the lungs, these products avoid combustion entirely. This method of use makes them discreet and convenient, as there's no need to chew, spit, or produce smoke.
The key difference between snus and nicotine pouches is that snus contains moist tobacco, while nicotine pouches are completely tobacco-free and contain only nicotine and other ingredients.
Why Footballers Use Snus
Football is a stressful sport, particularly at the top level. While the majority of players around the top divisions of most European leagues are paid handsomely, the high performance expectations, media scrutiny, frequent travel, and intense training and matchday scheduling all interact to create a stressful environment where mental health struggles can occur. This is where substance use can become prevalent—it can be a coping mechanism to relax.
In the recent Loughborough report, 41% of male players and 64% of female players reported using snus or nicotine pouches to relax, and a relaxing sensation was the most commonly reported effect of using these substances (1). Social factors were also cited as reasons for use. For example, younger players see senior players using snus or nicotine pouches and this often leads to them using these substances (1). In addition, being around others who use snus or nicotine pouches to alleviate boredom is another enabling factor of their use (1).
Footballers placing snus pouches into their mouth/gums. Image source: The Athletic.
Health and Performance Risks of Snus
Because snus and nicotine pouches don’t involve smoking, they’re naturally a preferred alternative to cigarettes from a health point of view, and have been reported as a compelling harm reduction alternative to smoking cigarettes (2). However, this doesn’t mean their use is risk-free, and about 95% of players from the Loughborough report did not use snus or nicotine pouches as an alternative to smoking (1).
Potential Health Risks
There is evidence that snus is detrimental to oral health, increasing the risk of gum disease and keratosis (i.e., an overgrowth or thickening of the skin in the gums) (3). Snus use has also been associated with poorer heart health markers, but the evidence isn’t very strong (3). Snus use is associated with greater risk of type 2 diabetes, with each additional box of snus consumed per week increasing risk by 8% in an analysis of over 50,000 Scandinavian men (4). This increased risk may be due to nicotine’s detrimental effect on insulin resistance (4). In addition, snus use has been linked to increased risk of pancreatic cancer (5); however, other studies have reported no such risk (6).
Potential Performance Impacts
Despite some claims that nicotine can improve some aspects of performance (e.g., reaction times, concentration), performance benefits are unlikely to exist, and snus or nicotine pouches may even worsen some aspects of performance (e.g., lower muscle force production, slower reaction times, greater mental fatigue) (3). In addition, nicotine use is associated with poorer sleep, it can reduce appetite, and can cause athletes to lose weight (7)—which could potentially impact illness and injury risk if players are chronically undereating.
Read our previous article on Football and Mental Health.
Summary
Overall, there are more negatives than positives associated with snus or nicotine pouch use. Therefore, it is likely wise to limit or totally avoid their consumption, particularly because developing a substance abuse issue may lead to other substance abuse issues (e.g., smoking, alcohol, drugs, etc.).
If you use snus to relax, I would encourage you to try some other stress-relieving activities like deep breathing, reading, yoga, meditation, hiking in nature, sauna use, or simply spending quality time with friends and family—whatever works to bring you to the present moment. And if you’re struggling to cope with stress, anxiety, and/or other mental health issues, I’d encourage you to get in touch with a licensed therapist. For any coaches reading this article, perhaps think if there are ways in which you or your club can better support players’ mental health.
If you are interested in levelling up your football skills through supplemental football training, contact us at admin@training121.com to book in with our coaches for a session. And remember to sign up to our (spam-free) mailing list to be notified when a new blog article drops.
Thanks so much for reading!
Patrick Elliott, BSc, MPH
Health and Nutrition Science Communication Officer at Training121
Instagram: @just.health.info
Twitter/X: @PatrickElliott0
References
(1) Read D, Cope E, Taylor L. Snus Use in English Professional Football: Report prepared for the English Professional Footballers’ Association. 2024. Available at: https://www.lboro.ac.uk/media/media/london/images/news/2024/snus-use-in-english-professional-football.pdf
(2) Clarke E, Thompson K, Weaver S, Thompson J, O'Connell G. Snus: a compelling harm reduction alternative to cigarettes. Harm Reduct J. 2019;16(1):62. Available at: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019-0335-1
(3) Kasper AM, Close GL. Practitioner observations of oral nicotine use in elite sport: You snus you lose. Eur J Sport Sci. 2021;21(12):1693–8. Available at: https://onlinelibrary.wiley.com/doi/10.1080/17461391.2020.1859621
(4) Carlsson S, Andersson T, Araghi M, Galanti R, Lager A, Lundberg M, Nilsson P, Norberg M, Pedersen NL, Trolle-Lagerros Y, Magnusson C. Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes: results from five pooled cohorts. J Intern Med. 2017 Apr;281(4):398–406. Available at: https://onlinelibrary.wiley.com/doi/10.1111/joim.12592
(5) Luo J, Ye W, Zendehdel K, Adami J, Adami HO, Boffetta P, Nyrén O. Oral use of Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in male construction workers: a retrospective cohort study. Lancet. 2007;369(9578):2015–20. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60678-3/abstract
(6) Araghi M, Rosaria Galanti M, Lundberg M, Lager A, Engström G, Alfredsson L, Knutsson A, Norberg M, Sund M, Wennberg P, Trolle Lagerros Y, Bellocco R, Pedersen NL, Östergren PO, Magnusson C. Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies. Int J Cancer. 2017;141(4):687–93. Available at: https://onlinelibrary.wiley.com/doi/10.1002/ijc.30773
(7) Read D, Carter S, Hopley P, Chamari K, Taylor L. Snus use in football: the threat of a new addiction? Biol Sport. 2024;41(1):201–5. Available at: https://pubmed.ncbi.nlm.nih.gov/38188104/
Technical Terms
Insulin resistance: This is when the body’s cells stop responding properly to insulin, a hormone that helps move sugar (glucose) from the blood into cells for energy. As a result, the body needs to produce more insulin to keep blood sugar levels under control. Over time, this can lead to higher blood sugar levels and increase the risk of developing conditions like prediabetes or type 2 diabetes.