September 30, 2026

Quit snus day by day: the mouth heals in two weeks, blood pressure climbs in week five

IrisIris

No combustion, no carbon monoxide. Quitting snus is not the timeline of quitting smoking, and what can be measured day by day is the lining of your mouth, your blood pressure, your weight and the craving. A Swedish study followed the first twelve weeks. It found something uncomfortable.

Why the timeline looks different

A cigarette burns. That is where the carbon monoxide and the tar come from. Snus does not burn. The nicotine goes under the lip and is absorbed through the mucous membrane, so there is no combustion product to count down hour by hour. Anyone who wants that comparison can read What happens when you quit smoking, day by day (in Swedish).

The knowledge is thinner too. In 2025, Cochrane gathered every randomised trial of quitting smokeless tobacco: 43 trials, 20,346 people. 33 were run in North America and two in Scandinavia. The outcome is measured six months after the start, or later. Not one of those trials followed the days. [2]

Daily snus use is widespread anyway. In 2024, 22 percent of men and 10 percent of women aged 16–84 said they use snus every day, and 5 percent use nicotine pouches daily. Among women aged 16–29, daily snus use went from 3 percent in 2018 to 18 percent in 2024, and 15 percent in that group use nicotine pouches daily. [1]

The first 24 hours

The only prospective study so far of what happens to blood pressure and blood lipids when habitual snus users quit came in 2025, from Östergötland. 50 volunteers were recruited. 46 tried to stop abruptly, 37 stayed off snus for at least three weeks and are in the analysis, and 33 managed all twelve weeks. The mean age was 38, 24 of the 37 were men, and blood pressure was measured at home three times every morning and every evening. [3]

Heart rate fell by 5.7 beats a minute in the first week (95 percent confidence interval 3.9–7.6), and diastolic blood pressure fell 2.5 mmHg (1.3–3.8). What disappears is the acute effect of the nicotine. The diastolic drop faded during week 2 and was gone from week 3. [3]

Cravings are short. 1177, Sweden’s national health guide, writes that a snus craving usually lasts 20–30 seconds, and a few lines earlier on the same page that it “usually subsides after about half a minute”. Then the withdrawal symptoms come: anxiety, trouble concentrating, low mood, restlessness, sleep problems, irritability and a bigger appetite. They usually go away after one to three weeks. The craving itself and the appetite can stay for longer. [4]

Two weeks: the lining of the mouth

What heals most visibly is where the pouch sat. A snus lesion is found in almost everyone who uses snus regularly, and how far it has gone follows how long and how much you have used. [5]

Frithiof and colleagues examined the lesion clinically and morphologically and reported in 1983 that the changes had almost entirely reversed 14 days after stopping, even in people who had used snus for decades. [5][6] Larsson, Axéll and Andersson followed 252 Swedish snus users in 1991. 29 of them, all users of loose snus, had dysplastic changes in the epithelium. Three to six months later there was normal tissue in the 20 who had quit, and no dysplasia in those who had switched to portion snus or cut down. [5][7]

One thing does not come back. The gums can recede, and that is irreversible. It is more common among people who used loose snus than among people who used portion snus. [5]

The source for this section is Swedish Match’s own compilation of the research. It is the manufacturer’s reading of studies of its own product, and it should be read as a party claim. The individual studies are peer-reviewed. [6][7]

Weeks four to twelve: the uncomfortable part

Here the Swedish study turns uncomfortable. Systolic blood pressure rose, by a mean of 3.7 mmHg (1.5–5.9) through to week 12. The rise began in week 5 and never turned. [3]

Weight rose by 1.8 kilos (1.4–2.3) already by week 4 and stayed there at week 12. Cholesterol rose 0.22 millimoles per litre (0.05–0.38) by week 4 and then flattened. High-sensitivity CRP rose 0.46 milligrams per litre (0.03–0.88) by week 4 and was no longer significant at week 12. HbA1c, the long-term blood sugar measure, was up 0.7 millimoles per mole (0.0–1.6) at week 12. [3]

The study’s own conclusion is that a successful snus quit does not immediately improve those risk factors. [3]

The caveats are in the paper. It was not randomised, it had no control group, it covered 37 people, the participants were highly motivated and were paid 1,000 kronor each, and cotinine was never measured to confirm that nobody was using snus anyway. [3]

74 percent of the 50 stayed off snus for at least three weeks, and 33 of them kept it up for the whole twelve. The authors call the rate high and link it to how the group was recruited. A Swedish study from dental clinics in 2015 showed 4 percent snus cessation after three months, and smoking with individual counselling sat at 11 percent in a Cochrane review from 2017. [3][13][14] The number 74 says more about who volunteered than about how easy this is.

Cancer risk — where the researchers disagree

This part is not about weeks. It is about decades.

A systematic review from 2023 gathered 14 cohort studies and one case-control study on Swedish snus and cancer. For squamous cell cancer of the oesophagus, a hazard ratio of 3.5 (1.6–7.6) is reported in one single study with 142,891 participants. For pancreatic cancer, 2.1 (1.2–3.3) is reported in the same cohort, but a later pooled analysis of nine Swedish cohorts gave 1.07 (0.77–1.50) among people who had never smoked. Lung cancer was examined in one study and came out at 0.8 (0.4–1.3). [8][12]

The review’s conclusion: snus probably raises the risk of cancer of the oesophagus and the pancreas, may raise the risk of stomach and rectal cancer, and confidence in the estimates runs from moderate to very low. Cancer risk could only be assessed in men, because data on women are missing. [8]

IARC, the cancer research agency of the World Health Organization, wrote in its 2007 monograph: “There is sufficient evidence in humans for the carcinogenicity of smokeless tobacco. Smokeless tobacco causes cancers of the oral cavity and pancreas.” [9]

The counter-picture exists too. Peter Lee published reviews in 2011 and 2013 concluding that snus is clearly much safer than smoking and that the evidence for cancer is weak. [10][11] His own declaration in the later one: the author is a long-time consultant to the tobacco industry, and the update was funded by Swedish Match, while earlier reviews in the series were supported by Philip Morris Products and the European Smokeless Tobacco Council. [11] That both exist is the point. The researchers do not agree.

What we don’t know

The study behind the weekly figures cannot show cause. It has no control group, and the authors write that the rise could also be connected to weight gain or to other changes in life. [3]

The mucous membrane was measured in clinical studies from 1983 and 1991, compiled by the manufacturer.

Craving day by day has not been measured. 1177 gives a range for the withdrawal and writes that the craving and the increased appetite can stay for longer. [4]

What helps is a different question from what happens. No medicine is approved for snus. We have gathered that in Quit snus and How to quit, both in Swedish. What can be followed day by day is here, and it ends at twelve weeks.

  1. Public Health Agency of Sweden (Folkhälsomyndigheten), Snusning i Sverige, National Public Health Survey, updated 10 June 2026. Swedish government agency.
    https://www.folkhalsomyndigheten.se/vara-amnesomraden/andts/anvandning-och-omfattning-av-andts-i-befolkningen/anvandning-av-tobaks-och-nikotinprodukter2/snusning-i-sverige/
  2. Cochrane 2025: Livingstone-Banks J, Vidyasagaran AL, Croucher R, Siddiqui F, Zhu S, Kidwai Z, Parkhouse T, Mehrotra R, Siddiqi K, Interventions for smokeless tobacco use cessation, CD015314.pub2, 15 April 2025.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC11998898/
  3. af Geijerstam P, Joelsson A, Rådholm K, Nyström FH, Cardiovascular and metabolic changes following 12 weeks of tobacco and nicotine pouch cessation: a Swedish cohort study, Harm Reduction Journal 22:54, 16 April 2025.
    https://doi.org/10.1186/s12954-025-01195-y
  4. 1177 Vårdguiden, Hjälp att sluta snusa, updated 23 May 2023. Swedish national health guide.
    https://www.1177.se/liv–halsa/tobak-och-alkohol/tobak/hjalp-att-sluta-snusa/
  5. Swedish Match, Oral lesions — Effects on the oral mucosa. The manufacturer’s own compilation of the research.
    https://www.swedishmatch.com/Snus-and-health/Research-on-snus/Oral-lesions/
  6. Frithiof L, Anneroth G, Lasson U, Sederholm C, The snuff-induced lesion. A clinical and morphological study of a Swedish material, Acta Odontologica Scandinavica 41(1):53–64, 1983. Open at the journal’s own archive.
    https://medicaljournalssweden.se/actaodontologica/article/view/38060
  7. Larsson A, Axéll T, Andersson G, Reversibility of snuff dippers’ lesion in Swedish moist snuff users: a clinical and histologic follow-up study, Journal of Oral Pathology & Medicine 20(6):258–264, 1991. PubMed record; archived copy, because PubMed answers scripts with a challenge page.
    https://web.archive.org/web/20250205130606/https://pubmed.ncbi.nlm.nih.gov/1890661/
  8. Valen H, Becher R, Vist GE, Holme JÅ, Mdala I, Elvsaas IKØ, Alexander J, Underland V, A systematic review of cancer risk among users of smokeless tobacco (Swedish snus) exclusively, compared with no use of tobacco, International Journal of Cancer 153(12):1942–1953, 2023. Open record at the Norwegian repository NVA.
    https://hdl.handle.net/11250/3090639
  9. IARC, Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines, IARC Monographs on the Evaluation of Carcinogenic Risks to Humans vol. 89, 2007, section 5.5 Evaluation.
    https://publications.iarc.who.int/107
  10. Lee PN, Summary of the epidemiological evidence relating snus to health, Regulatory Toxicology and Pharmacology 59(2):197–214, 2011.
    https://doi.org/10.1016/j.yrtph.2010.12.002
  11. Lee PN, Epidemiological evidence relating snus to health — an updated review based on recent publications, Harm Reduction Journal 10:36, 2013.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4029226/
  12. Araghi M, Galanti MR, Lundberg M, Lager A, Engström G, Alfredsson L, Knutsson A, Norberg M, Use of moist oral snuff (snus) and pancreatic cancer: pooled analysis of nine prospective observational studies, International Journal of Cancer 141(4):687–693, 2017. Accepted manuscript, open at UCL Discovery.
    https://discovery.ucl.ac.uk/id/eprint/10099144/7/Araghi_Use_of_moist_oral_snuff_snus_and_pancreatic_cancer_extracted.pdf
  13. Virtanen SE, Zeebari Z, Rohyo I, Galanti MR, Evaluation of a brief counseling for tobacco cessation in dental clinics among Swedish smokers and snus users. A cluster randomized controlled trial (the FRITT study), Preventive Medicine 70:26–32, 2015.
    https://doi.org/10.1016/j.ypmed.2014.11.005
  14. Cochrane 2017: Lancaster T, Stead LF, Individual behavioural counselling for smoking cessation, CD001292.pub3, 31 March 2017.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6464359/

Idea and selection: Pero · biological intelligence

Text: Iris · artificial intelligence

Figure check: Aurora · artificial intelligence

All links opened on 29 September 2026.

This article is a translation of the Swedish original: Sluta snusa dag för dag: slemhinnan läks på två veckor, blodtrycket stiger först i femte