A recent study published in the Harm Reduction Journal has revealed an unexpected rise in blood pressure among people who stopped using snus, a nicotine product that does not contain tobacco.
The study, led by Professor Fredrik Nyström from the Department of Health, Medicine and Caring Sciences at Linköping University, is the first of its kind to closely monitor physical changes in snus users who quit.
Snus is a smokeless nicotine product that is popular in Sweden and is becoming more widely used in the UK, the US, and other countries.
Unlike traditional tobacco products, nicotine snus (also called white snus) does not contain tobacco but still delivers nicotine to the user.
Nicotine is known to cause immediate increases in blood pressure and heart rate upon consumption. However, little was known about what happens to the body, particularly blood pressure, when people stop using it.
Most previous studies on snus were observational, comparing snus users to non-users, which made it difficult to establish clear cause-and-effect relationships. This new study took a different approach, directly observing changes in people who stopped using snus over a 12-week period.
The study involved 37 participants aged 18 to 70, most of whom (65%) used traditional tobacco snus, while 32% used nicotine-only snus (white snus), and 3% used both. It is important to note that tobacco snus is banned in the European Union except for Sweden, where its use remains common.
At the beginning of the study, participants provided blood samples, completed surveys about their diet and exercise, and had their blood pressure, weight, blood sugar, and blood lipids measured. These tests were repeated at four weeks and again at the end of 12 weeks. Participants also measured their blood pressure daily at home using semi-automatic equipment.
The researchers were confident that quitting snus would lower blood pressure. Their earlier research had shown that using nicotine snus raises blood pressure immediately, so they expected to see a drop when participants stopped using it.
Surprisingly, the opposite happened. Those who quit snus experienced an average increase of 3.7 mm Hg in systolic blood pressure. For context, systolic blood pressure measures the pressure in your blood vessels when your heart beats. An increase of 3.7 mm Hg is quite significant for people who started with normal blood pressure.
Nyström expressed surprise at the findings. “We can’t find anything that can really explain it,” he said. The participants did gain an average of 1.8 kilograms during the study, but Nyström noted that this weight gain should not have been enough to cause such a rise in blood pressure.
To compare, the increase in blood pressure was similar to what the research team observed in a previous study on the effects of eating licorice over a period of time. High blood pressure, also known as hypertension, is a well-known risk factor for heart disease and other cardiovascular problems.
The increase in blood pressure appeared within the first few weeks after quitting snus and remained at the higher level for the next two months. This steady rise was unexpected, as it challenges the assumption that quitting nicotine products would naturally lead to improved heart health.
What remains unclear is what would happen if these participants returned to using snus. The researchers had planned to compare those who quit with those who relapsed back into snus use, expecting that at least half of the participants would go back to their habit based on official statistics.
Surprisingly, nearly all participants—33 out of 37—managed to stay off snus for the entire 12 weeks, leaving the researchers with no relapse group to study.
Nyström believes that these findings suggest people with high blood pressure who quit snus might need closer medical monitoring.
He noted that it might be necessary to adjust blood pressure medications for some people who stop using snus. “If health care professionals encourage people to stop using snus, it would be best to also check their blood pressure after a while,” Nyström said.
The study also raises questions about what happens to blood pressure if someone starts using snus again after quitting.
Unfortunately, the researchers could not explore this due to the unexpected success of the participants in staying snus-free. Nyström suggested that more research is needed to understand why blood pressure rises after quitting snus and what role nicotine might play in this process.
This study is a reminder that quitting nicotine products, even smokeless ones like snus, can have unexpected health effects. For those with pre-existing blood pressure issues, regular monitoring might be important during the process of quitting.
While stopping snus use is generally seen as a positive step for long-term health, the findings suggest it may come with short-term risks that need to be managed with proper medical care.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
The research findings can be found in Harm Reduction Journal.
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