Anecdotal evidence from players and staff suggests that snus (a smokeless tobacco pouch placed between the lip and gum) is commonly used among professional footballers in England. Snus use has been associated with a variety of health conditions in the general population, but at present, there is no available evidence about how and why professional football players use snus to inform wellbeing plans. The aim of this research was 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 research adopted a two-stage approach involving a consultation with 16 performance and medicine staff across the football league and a survey with professional male and female football players in England. In total, 628 and 51 eligible participants were recruited from the men’s English Football League and Women’s Super League respectively. Overall, 18% of male players, and 22% of female players use snus currently, and 42% and 39% respectively have used snus at least once in the past. Importantly, although players often used the term snus, most players used legally available tobacco-free nicotine pouches. Players typically reported using both snus and nicotine pouches socially to relax and spend time with teammates. Most players did not report any performance benefit to use, but those who did perceived an improvement in mental readiness.

Most players reported at least one indicator of nicotine dependence (e.g., use without awareness or intention). Short term withdrawal symptoms were also common including cravings, irritableness, restlessness, and anxiety. Critically, although players reported intending to quit, difficulty stopping was linked to the addictiveness of nicotine, the prevalence of use in football, the availability of pouches, and concern over seeking support.

Support for players looking to stop or reduce their use should include relevant educational materials, nicotine weaning guidance, external support options separate from club channels, and complementary stress management techniques. Additionally, avoiding bans on snus, normalising help-seeking behaviour, and providing career aftercare can all contribute to supporting player wellbeing.