“I used to have the odd cigarette on a night out,” wrote Jamie Vardy, the Leicester City striker and 2016 Premier League winner, in his autobiography, “but one of the lads introduced me to snus when I signed for Leicester and I found they helped me chill out.”
Professional soccer players in the United Kingdom are using nicotine pouches or snus in significant numbers, according to a new study. The resulting media coverage has overwhelmingly portrayed this as negative. Almost entirely ignored is the role of snus and pouches in harm reduction—together with the relevant fact that many players, including some of the most famous, have smoked.
The “first of its kind” study was commissioned by the Professional Footballers’ Association (PFA) and conducted by researchers at Loughborough University. It aimed “to explore snus use in men’s and women’s professional English football to better understand prevalence, motivations, sources, and perceived health and performance effects.”
The researchers surveyed 628 men currently playing in the Premier League or English Football League, and a smaller sample of 51 Women’s Super League players. Eighteen percent of the men and 22 percent of the women reported current use of snus or nicotine pouches.
The two product types are very similar: Both are placed between the upper lip and gum to allow the person to absorb nicotine. Snus contains tobacco, while the more recently developed pouches contain no tobacco, just nicotine extract and fillers. Players in England mostly use nicotine pouches, though they’ll often refer to them as “snus,” the researchers noted.
People always use drugs for reasons, and pressure to perform at a high level in public is a readily identifiable factor here.
The survey asked footballers why they used the products. Forty-one percent of the men who responded, and 64 percent of the women, said that seeking to relax was a reason they began. And for 43 percent of the men and 55 percent of the women, stress management was a reason for their continued use.
Similar numbers cited dealing with boredom as a reason for continued use, while “my teammates were using it” was another major reason for starting.
Most used outside of training or games, but smaller proportions of those using (10 percent of men, 27 percent of women) used during games. And overall, 39 percent of men and 55 percent of women using perceived performance benefits—most commonly “mental readiness” and “increased focus.”
People always use drugs for reasons, and pressure to perform at a high level in public is a readily identifiable factor here. Research has found that nicotine may have cognitive benefits, while stress relief is a common motivation for use.
Findings heavily that were emphasized in media reporting of the new study included that 53 percent of men using the products, and 73 percent of women, experienced “elements of nicotine dependence,” like withdrawal symptoms. This in itself does not entail serious harms, however, and snus and pouches fall very low on the nicotine product risk continuum. That doesn’t mean no potential harms exist, but risks are low and headlines inflate them.
About half of the men using the products—though interestingly, very few of the women—also said they were likely to try to quit in the next year.
“If its use helps those competing at high levels in sport to relax or focus better, then why should we be overly concerned?”
Paddy Costall is one of the founders of Knowledge-Action-Change, a UK-based organization working on tobacco harm reduction, and a lifelong soccer fan.
“If its use helps those competing at high levels in sport to relax or focus better,” he asked, “then why should we be overly concerned?”
“The physical nature of sports, especially football, present obvious risks of injury, but these are mitigated by the rules and structures in place for player welfare,” Costall told Filter. “Similarly, there are risks involved in using psychoactive substances, but again these should be viewed in context.”
Costall recalled how in the 1960s, some players were involved in advertising campaigns for cigarettes, while large numbers were still smoking in the 1970s.
Few were as iconic as Johan Cruyff. The Dutch maestro, a three-time Ballon d’Or winner, smoked heavily before, during and after his 20-year playing career, even lighting up at half-time during the 1974 World Cup final. He quit after suffering a heart attack in 1991, and went on to front smoking cessation campaigns. He died of lung cancer in 2016.
Many more recent stars of the world game, such as David Ginola, Wayne Rooney and Zinedine Zidane, have also smoked, as have some current players, like Mario Balotelli, once of the Premier League and now playing in the Turkish Süper Lig.
The new study emphasized that over 90 percent of players using pouches or snus in the English game are not using them to replace far more harmful cigarettes. But the minority who do use them for this purpose matter.
There’s also the question, given the value players seem to find in nicotine, of what they might be doing instead if safer products were not available—reminiscent of debates where alarm over youth vaping has masked the virtual disappearance, in some places, of youth smoking.
The big untold story in the soccer-focused coverage is the central role of snus in Europe’s most successful example of smoking cessation. Smoking rates in Sweden, where snus has replaced cigarettes on a large scale, have fallen to almost 5 percent, leaving the country close to declaring itself “smoke-free.”
Costall said the way the new study has been framed serves to “demonize a product which is relatively harmless and used by many people, in all walks of life.”
The “Swedish experience,” leading to notably low cancer rates, shows how snus can have a “beneficial effect” through substitution that’s by far its biggest impact on public health, Costall said.
In the UK, which is fairly supportive of tobacco harm reduction, nicotine pouches (also with great harm reduction potential) are legal; but snus is strangely banned. Despite nicotine’s possible performance-enhancing benefits, it is not prohibited in sports by the World Anti-Doping Agency.
Costall said the way the new study has been framed serves to “demonize a product which is relatively harmless and used by many people, in all walks of life.”
“Obviously snus is not for everyone, as the figures in the study show,” he concluded, “but the overwhelming evidence, concerning snus use more widely, is that it is a relatively safe way to use a relatively benign substance, nicotine.”
Photograph by Brad Tutterow via Flickr/Creative Commons 2.0
The Influence Foundation, which operates Filter, has received restricted grants and donations from Knowledge-Action-Change. Filter’s Editorial Independence Policy applies.