Almost one in five male professional players who took part in a new survey are using snus, nicotine pouches or both - and nearly half would like to stop using snus within 12 months.
The study by Loughborough University, commissioned by the Professional Footballers’ Association (PFA), also identified that two out of five players had tried the pouches at least once.
The report suggests the actual usage figures are "likely" to be higher because players may not want to disclose they use snus even in an anonymous survey, which was the first research on its specific use in football.
As many as 628 male players, based at either Premier League or EFL clubs, were surveyed - as well as 51 Women’s Super League players.
Of the male respondents, 18% said they currently use snus while 42% said they had tried the substance at least once. The figures for female players were 22% and 39% respectively.
Nearly half of the men (48%) indicated a desire to quit using snus in the next year, but just 9% in the WSL.
Interviews were also conducted with 16 professional club performance and medical staff.
What is snus?
Snus is a tobacco product in a sachet, similar to a small tea bag, which is placed under the lip and releases nicotine into the bloodstream.
It is illegal to be sold in the United Kingdom but not against the law to use, while tobacco-free nicotine pouches are legal.
Most players used nicotine pouches rather than tobacco-based snus. However, they often referred to nicotine pouches using the term ’snus’.
Why do footballers use snus?
Of the 45 men and 11 women that perceived a performance benefit from using snus, 29% and 55% respectively cited improved mental readiness as the key benefit.
Of the 84 men and 11 women who replied as to whether they had experienced certain effects, 56% and 36% respectively said snus had helped them relax.
It is used most commonly after training and after matches, with one of the performance and medical staff saying players used snus as a "coping mechanism".
The survey found the pouches are also used as an appetite suppressant, and that users often started using the products in a bid to fit in with other often more senior team-mates. For male players, 56% gave this as a reason, rising to 73% among women.
What are potential negative impacts?
The report noted that a review of available evidence suggests snus use is associated with an increased risk of oesophagus and pancreatic cancer in comparison to non-smokers, and to an increased risk of cardiovascular disease.
There is also strong evidence of an association between snus use and mouth lesions.
A majority of male players (58%) and more than three-quarters of female players (86%) in the study said they had not previously received any education about snus.
In March 2023, the PFA said a growing number of players were using snus with some receiving help for addiction.
More than half of the male users in the survey (53%) and almost three-quarters of the female users (73%) reported elements of nicotine dependence - such as cravings and using without awareness or intention - while withdrawal symptoms reported included anxiety, irritability and restlessness.
Nearly two-thirds of the male respondents (62%) in the survey said they sourced snus products from a shop while just over half the women (55%) purchased them online.
The report also highlights the risk of an adverse anti-doping finding if products have been contaminated. It adds that club bans had not been effective in deterring use, and recommends personalised, external support - avoiding stigmatising those seeking help.
"This is an important piece of work that will help players, clubs and medical staff make informed decisions about snus use," said Dr Michael Bennett, the PFA’s director of player wellbeing.
"Importantly, these findings tell us that while a lot of players appear to be looking to substances like snus as a coping mechanism to handle the growing demands of the game, many are not fully aware of its effects and addictive qualities."
Dr Daniel Read, lead researcher and lecturer at the Institute for Sport Business, Loughborough University London, added: "The findings show that snus and tobacco-free nicotine pouch use among professional footballers is higher than typically seen in the UK general population and players often use these products to relax and manage stress."