The days of Johan Cruyff and George Best having a crafty snout at half-time are long gone but professional footballers will always need a way to unwind and it seems that a growing number of them are turning to nicotine pouches. Last week, a report commissioned by the Professional Footballers’ Association found that one in five footballers who completed an online survey consume what the authors call “snus”. Another twenty per cent have used it at least once in the past.

Baseball players are well known for using chewing tobacco to help them concentrate, but although nicotine has the potential to be a legal and permitted performance enhancing drug in football, only 10 per cent of the men who used “snus” consume it during the match, whereas 86 per cent of them use it after training and 85 per cent use it after a game. Most of them say it helps them relax. Typical comments quoted in the report include “I only use it on nights out as a replacement for alcohol”, “Only take it when drinking” and “I only used it on occasional nights out”. 

It appears that use of oral nicotine is far higher among professional footballers than among the general population, and the reasons for that are worth investigating, but it’s not exactly hell-raising behaviour, is it? Of all the things young men could be getting up to, sticking a little sachet under their lip and absorbing nicotine is at the bottom end of the risk continuum. The report cites a study from 2007 to claim that “snus use is associated with an increased risk of oesophagus and pancreatic cancer”, but that study found no statistically significant association with oesophageal cancer and subsequent studies found no association with pancreatic cancer either. In 2017, a pooled analysis of nine large studies concluded that “snus use was not associated with risk of pancreatic cancer”. 

The massive Global Burden of Disease Study published in the Lancet, found that some forms of chewing tobacco are linked to oral and oesophageal cancer, but snus is not one of them. This has since been confirmed in a systematic review. In 2001, the European Commission took the unprecedented step of removing the cancer warning on snus in the only EU country that was allowed to sell it: Sweden. (Sweden negotiated an exemption from the EU-wide ban when it joined the bloc in 1995 and today has by far the lowest rate of smoking in Europe. This is not a coincidence, but it is a story for another day.)   

In any case, snus is not widely used in the UK thanks to the British government’s failure to re-legalise it after Brexit and so, as the report notes, “most players used nicotine pouches rather than tobacco-based snus”. Since nicotine pouches do not contain tobacco, toxicological analysis suggests that they are even less risky to health than snus. Consisting of little more than cellulose, nicotine and flavourings, they are probably the safest recreational nicotine product ever invented. 

So what is the problem? Swedish and Norwegian sportsmen would scoff at the idea that this is some sort of crisis. Nicotine is obviously addictive and the BBC’s story headlined “Half of players using snus would like to stop – study” implies that a large number of footballers who use oral nicotine are hopelessly addicted. Not to be pedant, but the question to which 48 per cent of the male footballers responded in the affirmative was not “Would you like to quit?” but “How likely are you to attempt to quit using snus in the next year?”. That is not quite the same thing. Admittedly, eight per cent of them agreed with the statement “Sometimes I feel like snus rules my life” and 26 per cent agreed with the statement “I crave snus”, but there are nicotine-free pouches out there if they want to wean themselves off.

… a failure of governance leads to a political overreaction and the rights of adults to consume a very low risk product are curtailed

The greater, unspoken concern is that widespread use of nicotine pouches among professional footballers could inspire children to emulate their idols. It is easy to imagine a moral panic erupting around nicotine pouches in schools much like the panic about disposable vapes. There was a harbinger of this last week with a sensationalist Channel Four documentary titled “Snus: Hooked on Nicotine”. The government has done nothing to head this off at the pass. These products have been around for five years and no attempt has been made to regulate them. So far, the industry has been successfully self-regulating by instructing retailers not to sell them to minors, adding health warnings and capping nicotine levels, but none of these are legal requirements and there is nothing to stop less scrupulous companies entering the market with extra-strong pouches, child-friendly packaging and deceptive marketing. 

I hesitate to write this in case it gives professional busybodies and Wes Streeting ideas, but there is a danger of this turning into Elf Bar II in which a failure of governance leads to a political overreaction and the rights of adults to consume a very low risk product are curtailed. Given the political class’s penchant for banning things first and asking questions later, this is a threat that users of nicotine pouches need to be alive to.