Purpose: To compare acute effects of moist snuff with or without nicotine and red wine with or without alcohol on prandial hormones and metabolism.Basic procedures and methods: Two deciliters of wine, with or without alcohol, were taken together with a standardized supervised meal in 14 healthy women and men. All participants also combined the meal with usage of with moist snuff, with or without nicotine. The snuff was replaced hourly at each of the four settings, i.e. snuff with or without nicotine combined with red wine with or without alcohol, that started at 0800 oclock and were finished at noon.Main findings: We found ghrelin levels to be more efficiently suppressed when drinking red wine with alcohol compared to non-alcoholic wine by analyzing area under the curve (AUC). AUC for regular wine was 370 +/- 98 pg/ml x hours and 559 +/- 154 pg/ml x hours for de-alcoholized red wine, p < 0.0001 by general linear model. The postprandial metabolic rate was further elevated following alcohol containing red wine compared with nonalcoholic red wine (p = 0.022). Although glucose levels were not uniformly lower after alcoholic red wine, we found lowered glucose levels 3 h after the meal (mean glucose wine: 4.38 +/- 0.96 mmol/l, non-alcoholic wine: 4.81 +/- 0.77 mmol/l, p = 0.005). Nicotine-containing moist snuff (AUC: 1406 +/- 149 nmol/ml x hours) elevated the levels of serum cortisol compared with nicotine-free snuff (AUC: 1268 +/- 119 nmol/ml x hours, p = 0.005). We found no effects of nicotine or alcohol on feelings of satiety.Conclusions: Alcohol in red wine augmented the postprandial suppression of ghrelin and it also lowered postprandial glucose 3 h post-meal. These effects are in line with observational trials linking regular intake of moderate amounts of red wine with lower risk for diabetes.