Not so long ago, there were significantly fewer nicotine products to choose from, such as cigarettes and brown snus. Nowadays, there is a plethora of new products, especially white snus (so-called nicotine pouches) and e-cigarettes (vapes). The way in which the product is delivered to the body has a great deal of importance for the harmful effects. Common to all the products described below is that they contain nicotine, or are used in products that contain nicotine. For each product there is an explanation of what the product is, what nicotine content it has and what risks are associated with use.
About nicotine
Nicotine is a central stimulant and activates the central nervous system. It is highly addictive, and many people have difficulty quitting once they get hooked. Research also shows that nicotine, regardless of the product it is packaged in, has other negative effects on health.
For example, the cardiovascular system is negatively affected with increased heart rate and blood pressure, and the risk of type 2 diabetes increases with nicotine use. Concentration is also negatively affected by nicotine addiction, although users may believe that it is the other way around because withdrawal disappears when they take a puff or pop a pill.
Children's growing brains are particularly sensitive to nicotine. When children try products containing nicotine, it is common for them to feel dizzy, nauseous and even vomit. Nickokick is a collective term for the effects nicotine has on the body, such as increased heart rate, palpitations and a feeling of increased alertness. It is the nickokick that many young people strive to feel, and which makes them want to repeat the behavior.
Description of products
White snuff
Brown snus and white snus
E-cigarettes and vaping
Heat-not-burn (HTP)
Cigarettes
Hookah
Cigarillos
Break filter cigarillos
Cigars
Pipa
Chewing tobacco
Clickballs and taste cards
SNU extension
Note: There is a big difference between snus and cigarettes in the description of nicotine absorption. Snus users absorb more than twice as much nicotine into their blood from one puff, compared to the absorption per cigarette for a smoker.
White snus (also called nicotine pouches and tobacco-free snus)
White snus has been sold in Sweden since 2016. It is therefore one of the newest nicotine products on the market. White snus is available in a huge variety of flavors. White snus is presented in marketing as fresh and new (= harmless), and this is reinforced by the design of the cans and the names of the flavors.
White snus is said to be free of tobacco, but most varieties contain nicotine, which is extracted from the tobacco plant. White snus often contains a high level of nicotine, and is therefore not tobacco-free. Just like other products containing nicotine, white snus is therefore harmful to health. More and more young people are using the product.
White snus is cheaper than many other nicotine products. A box of 20 puffs can be purchased for 25 kronor, up to around 45 kronor. (2025). This is because white snus is taxed based on nicotine tax, instead of tobacco tax. The low price, compared to conventional nicotine products, is one of the things that contributes to high use among young people.
Risks
There are several risks with white snus. The flavors attract children and young people who quickly become highly addicted. The heart and blood vessels are affected by nicotine, which raises blood pressure and reduces the blood vessels' ability to dilate.
The long-term effects of nicotine snus are unknown as they have only been in use for less than 10 years. However, based on the nicotine content, there is good reason to warn of increased risks of dying from a heart attack or stroke, similar to what has been seen with regular snus. There is much evidence to suggest that the risk of developing diabetes (type 2 diabetes) is similar to that of using other nicotine products.
New studies show that nicotine itself increases the risk of infertility, miscarriage, birth defects and sudden infant death syndrome, which is believed to also apply to the use of white snus. White snus also causes severe damage to the mucous membrane in the mouth, which has proven to be difficult to heal.
The precautionary principle is what is recommended by many doctors and authorities, that is, one should refrain from white snus because there are such strong indications that it is negative for health.
Nicotine content
There is no maximum limit for white snus in the legislation today. This means that the nicotine strength varies greatly between different products, some of which have a very high content. The strongest white snus on the Swedish market is currently (2025) over 40 mg/g. (This can be compared to the maximum limit in a cigarette being 12 mg/g). How much nicotine the body absorbs is also related to the PH value in the snus.
On cans containing white snus there is often a type of marking that claims to show the nicotine content. The marking can consist of symbols such as round circles, hearts, stars, paws, etc. This marking is not regulated by authorities or laws, but is the tobacco companies' own system. The marking is misleading for the consumer because it is not general, but differs between different brands. The snus also contains substances added that make the user more easily addicted.
Brown and “White” snus
Brown snus and white snus are sometimes called tobacco snus because they contain plant fibers from the tobacco plant. These snus varieties contain nicotine but also a variety of other substances, such as heavy metals, pesticide residues and tobacco-specific nitrosamines.
Brown snus is available as loose snus and in portions. White is in many ways similar to brown snus. It has largely the same content, but is only available as portioned snus. What also differs from brown snus is the material in the bags. It has a different structure and is lighter in color. The purpose of the material is to make the snus not leak as much. Hence the name white, because brown snus juice does not leak when you snuff this variant of snus.
Risks
The use of brown snus and all white has several known risks. Among other things, it affects the heart and blood vessels by raising blood pressure and reducing the vessels' ability to dilate. Those who use snus therefore have an increased risk of dying from a heart attack or stroke. Using snus means a greater risk of developing diabetes (type 2 diabetes).
New studies also show that the nicotine in brown snus increases the risk of infertility, miscarriage, birth defects and sudden infant death syndrome. Brown snus also causes damage to the mucous membrane in the mouth, and the risk of cancer. Swedish research shows that snus users have a greatly increased risk of dying prematurely. (insert link to Marja-Lena Byhamre's research). This research was conducted on brown snus, and therefore it is still unclear whether the same risk exists when using white snus.
Nicotine content
Just like white snus, there is no maximum limit for brown and white snus. This means that there are products with widely varying nicotine strengths, some of which have very high levels – although lower than for white snus. The stronger varieties on the Swedish market currently have around 40 mg/g.
E-cigarettes and vapes
E-cigarettes (Electronic Nicotine Delivery Systems) are battery-powered electronic devices used to inhale vapor. E-cigarettes have a liquid container that contains a liquid (often called e-juice or e-liquid), which usually contains nicotine. There is a huge range of e-cigarette variants, for example:
• products you design and build yourself
• ready-made devices where you refill the liquid when it runs out
• Devices where you insert a pre-loaded "podcast" – so-called click systems
• Disposable vapes
Many e-cigarette products are rechargeable. The products are designed in a stylish or cute design and there is a very large selection of flavors of liquids, many of which attract children and young people. Examples of flavors aimed at children are tuttifrutti, bubble gum, strawberry Icecream, cotton candy, gummy bears and Ice cotton candy. Today there are also technical solutions that allow the user to change the flavor with each puff.
A disposable vape, which is thrown away when the contents run out, costs around 80-100 SEK/piece. Refillable vape pens cost from 100 SEK and up. Refilling liquid costs from 50 SEK. (Cost 2025). E-cigarettes with a click system will be significantly cheaper in the long run, which attracts the price-sensitive group of young people.
Risks
Most e-liquids contain nicotine and are therefore addictive. Many of the substances in e-cigarettes are approved for use in food, but become harmful when heated. Inhaling these substances can cause damage to the lungs and respiratory tract. Deaths have been reported when children and pets have ingested the liquid.
Nicotine content and strength
According to Swedish law, there can be a maximum of 20 milligrams of nicotine per milliliter of e-liquid. How much nicotine the user ingests depends on how many puffs are taken. A vape, even disposable vape, contains thousands of puffs. Since an e-cigarette is not used up as quickly as a conventional cigarette, it is more difficult to determine how much a vaper ingests during each smoking session. A vaper can take more puffs in a row than a traditional smoker and thus ingest much more nicotine per smoking session.
The sleek and sleek design of e-cigarettes means they are discreet and the user can vape anywhere, unlike traditional cigarettes. Compared to smoking in the past, vapers can therefore have a more constant supply of nicotine, and thus develop a stronger addiction.
Heat not burn
Heat-not-burn, also known as Heated Tobacco Product (HTP), has been around since the 1980s, and is a battery-powered electronic device. Initially, all HTP products contained tobacco and relatively early on they began to be designed to resemble conventional cigarettes. When the tobacco is heated in the electronic device, a vapor is released that the user inhales.
The tobacco in Heat-not-burn products consists of a specially rolled, tightly packed tobacco called sticks. These look like a shorter version of a cigarette and come in a variety of tobacco flavors. The user places the sticks in a container where it is then heated to release the nicotine smoke that the user inhales. Heat-not-burn does not emit as much smoke as a traditional cigarette.
HTP products have been developed in recent years, so that they are now also available without tobacco, but with nicotine. The new variant has flavors such as menthol, and the technical device no longer looks like a conventional cigarette. The best-known HTP product in Sweden is Iqos, which was developed by Philip Morris. Iqos stands for "I quit ordinary smoking". HTP products require more care, such as cleaning, and have therefore attracted fewer users.
Risks
Like other tobacco and nicotine products, HTP is addictive because the user inhales nicotine. The manufacturers claim that Heat-not-burn is less harmful because the contents are heated to a lower temperature than a traditional cigarette, but independent studies refute this claim. According to the WHO, the risks of heat-not-burn are equivalent to those of traditional cigarettes. They are not recommended for quitting traditional cigarettes.
Nicotine content
Although Heat-not-burn products are regulated in the Tobacco Act (2018:2088), there is no maximum limit for nicotine content in the product (2025).
Cigarettes
Traditional cigarette smoke contains more than 7000 substances, including tar, carbon monoxide, formaldehyde, hydrogen cyanide, benzene, cadmium and nicotine. After a puff, nicotine reaches the brain within 10 to 20 seconds.
Cigarettes can be purchased pre-rolled with filters, pre-rolled without filters, and as rolling tobacco (rolling your own cigarettes). Cigarettes may not have any added flavors. However, there are products on the market that can be added to add flavor, such as clickballs and flavorcards. (See below – links) A pack of cigarettes costs between 70–90 kronor (2025)
Risks
Strong scientific support for increased risk of around 60 diseases, including several forms of cancer, several lung diseases, several cardiovascular diseases, type 2 diabetes, pregnancy complications and tooth loss.
Nicotine content & strength
Cigarettes are legally allowed to contain a maximum of 1 mg/g of nicotine. A cigarette contains just over 1 gram of tobacco, which means that a smoker ingests approximately 1 mg of nicotine per cigarette smoked, depending on how the smoker smokes (inhales) and the length of the butt.
Hookah
Hookah is a tobacco product that is inhaled, in which large amounts of smoke are inhaled, larger than when smoking traditional cigarettes. The smoke contains many toxic and carcinogenic substances, including nicotine, carbon monoxide, tar, heavy metals and aldehydes. Hookah tobacco is made from raw tobacco and fruit flavors or other flavorings. The tobacco is like a moist mass.
To get the tobacco burning in the hookah, charcoal or wooden sticks are added. When the tobacco starts to burn, the user draws the smoke into the water container. There, the smoke is cooled and moistened, allowing even an inexperienced smoker to take deep throat puffs without coughing.
There is also water pipe tobacco without nicotine, and the use is not addictive. However, other toxic substances and large amounts of smoke are still inhaled.
Risks
It takes a long time to ventilate the lungs from harmful substances after smoking hookah. In the short term, use can cause increased heart rate, impaired lung function and carbon monoxide poisoning. The risk increases if you smoke several times a day, or a lot in a short period of time (over a few days). Long-term risks include respiratory infections, COPD, lung cancer and cardiovascular disease.
Passive smoking is also a big problem, as it emits such a large amount of smoke that even those around them breathe it in. Studies show that tobacco smoke from hookahs is just as harmful as smoke from traditional cigarettes.
Nicotine content and strength
One hour of smoking is estimated to be equivalent to the smoke from around 100 traditional cigarettes. However, there is no reliable information on how much nicotine is ingested when using a hookah.
Cigarillos
A cigarillo is traditionally rolled in tobacco leaves. The outer wrapper is tobacco leaves. Cigarillo use has previously been associated with older ladies and gentlemen, but when flavoring of traditional cigarettes was banned, cigarillos were modernized. The cigarillos were reshaped to look more like traditional cigarettes, filters were added, and menthol flavoring was added. The latter are called break green filter cigarillos.
Risks
Strong scientific support for increased risk of, among other things, several forms of cancer, several lung diseases, several cardiovascular diseases, type 2 diabetes and tooth loss.
Nicotine content and strength
A cigarillo typically contains 3g of tobacco and thus about 3 times as much nicotine as a regular cigarette. The smoke is usually inhaled.
Cigars
Break filter cigarillos
See under cigarillos
The classic tobacco product. It is a product that few people use regularly today. Traditionally, the user does not inhale the smoke into their lungs, but rather holds the smoke in their mouth.
Risks
Strong scientific support for increased risk of, among other things, several forms of cancer, several lung diseases, several cardiovascular diseases, type 2 diabetes and tooth loss.
Nicotine content and strength
Cigars come in too many sizes and qualities to be easily described. The largest cigars can contain 400mg of nicotine. Cigar smokers rarely take deep throat puffs, thereby reducing their exposure to nicotine.
Pipa
Also a classic tobacco product that few people use today. This product is drawn into the lungs. The user often uses the pipe for a long time, which means that a lot of smoke is inhaled.
Risks
Strong scientific support for increased risk of lung cancer, lip cancer, tongue cancer and throat cancer, several lung diseases, several cardiovascular diseases, type 2 diabetes and tooth loss.
Nicotine content and strength
Pipe tobacco traditionally contains higher levels of nicotine than cigarettes. However, pipes are smoked in a different way and rarely with a throat puff, so exposure to nicotine is not particularly high. The management of keeping pipes in good condition has led to a decrease in the number of pipe smokers, and in Sweden the proportion of pipe smokers is at most 1-2%.
Accessories
Click balls and taste cards
It has long been known that flavoured cigarettes contribute to smoking among young people, and are therefore banned in Sweden. However, this ban is circumvented with the help of click balls and flavour cards. Click balls are inserted into each cigarette, and the flavour cards are inserted into the package, to flavour the product. These are available in flavours such as cherry, mango, ice blast, peach, strawberry and more.
Risks
The risk is that flavorings lower the threshold for trying and becoming addicted to cigarettes. If so, the risks are the same as for smoking.
Nicotine content
The accessory itself does not contain any nicotine, but the nicotine you ingest varies depending on the strength of the cigarettes you smoke.
The Future
Synthetic nicotine will probably become increasingly common in the near future, which will help to ensure that products can be presented as harmless in a completely new way – since it is tobacco that most people believe has harmful effects on health.
Tips
To stop
For those who want to quit nicotine, there are many good alternatives, such as medication and supportive conversations. Using new nicotine products, such as e-cigarettes and white snus, when quitting nicotine (link to our theme series on nicotine cessation) is not recommended by either the WHO or the National Board of Health and Welfare.
Read Tobacco Facts' article series about nicotine cessation
Read about increased abstinence when quitting snus
Do you want to quit? Contact the Quit Smoking Line or a tobacco prevention clinic at your hospital.
