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Some named differences in how the product was used (need to spit out the juices): You just put it in, and what I've heard, if you accidentally swallow some, it can cause hiccups, or like maybe throw up, so they are trying to make it safer to chew tobacco, and they made little packets and you just chew on a packet, or suck on a packet and spit it out.SF, male, 23 Smokers also expressed some confusion about whether or not snus products actually required spitting or not

Banerjee J, Al-Wadei HA and Schuller HM

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6 and 7 Appendix B: Risk of bias assessment (Rob 2): randomized controlled trials Appendix C: Risk of bias assessment (ROBINS-I): non-randomized studies NI, no information