Snus health
Some articles about snus and health
Smoking, but not using snus, increases risk of diabetes
Men who smoke run a substantial risk of developing diabetes. On the other hand, there is no evidence to indicate that using snus (moist snuff) increases such a risk.
These are the results of a collaborative study involving Sunderby Hospital, Luleå, and Umeå University. The study, carried out under the leadership of Associate Professor Mats Eliasson, is published in the August issue of the Journal of Internal Medicine. Co-authors of the article are Kjell Asplund, Brad Rodu, and Salmir Nasic. In Sweden some 250,000 people suffer from type 2 diabetes, so-called age-related diabetes. The causes are most often a combination of heredity, obesity, and physical inactivity. Recent research has also singled out psychosocial stress and smoking as underlying factors. Since snus users are exposed to at least as much nicotine as smokers and using snus is extremely common in northern Sweden, the research team has investigated whether using snus increases the risk of contracting type 2 diabetes. Within the framework of the MONICA study in northern Sweden, 3,384 men between the ages of 25 and 74 were studied. Just over half were re-examined after 9 years. The occurrence of diabetes was almost doubled among smokers but did not increase among snus users. In the follow-up smokers evinced a quadrupled risk of developing diabetes and ex-smokers a tripled risk. Among snus users no one developed diabetes. The differences in risk could not be explained by physical activity, alcohol consumption, or various degrees of abdominal fat. The study supports earlier studies from the MONICA group that did not indicate any increased risk of heart attacks among snus users, unlike smokers, whose risk did increase.
From Study in Sweden - http://www.sweden.se/templates/cs/News____9606.aspx
EU missing chance to cut smoking
Snuff is becoming more popular The European Union has been urged to revamp its current partial ban on the sale of smokeless tobacco products. An alliance of researchers and anti-tobacco activists says some products - including forms of snuff - which might help people quit smoking are banned. However, others, such as chewing tobacco from India, which are highly toxic, are not. The research, published in the journal Tobacco Control, calls for new rules to ban the most harmful products. It stresses that no form of smokeless tobacco is completely harmless. But it says that some products, in particular a Swedish form of snuff called snus, are considerably less harmful than others. However, current EU regulation bans snus (except in Sweden), but permits the marketing of highly toxic varieties of chewing tobacco - in particular those from India.
Lower disease ratess
In Sweden, snus is manufactured and stored in such a way as to cause it to deliver lower levels of some harmful chemicals found in other tobacco products. Unlike most forms of snuff, it is not snorted up the nose, but placed behind the upper lip. Research has shown that snus - and some US smokeless tobacco products - are at least 90% less hazardous than cigarette smoking. It has also shown that in Sweden the high use of snus has contributed to a low rate of cigarette smoking in men - and thus a low rate of smoking-related death in the country. Snus is still addictive, but almost a third of former male smokers use snus to help them give up. Writing in the journal, the researchers say: "For smokers who are addicted to nicotine, and cannot or will not stop, it is important that they can take advantage of much less hazardous forms of tobacco. "We argue that the ban on some of the least harmful forms of smokeless tobacco throughout the EU should be replaced by a regulatory framework applying to all smokeless tobacco products and focusing on eliminating those that are most harmful." This could be achieved by setting specific limits on the levels of cancer-causing agents in smokeless tobacco products, they say. Among the groups who took part in the research are the anti-smoking charity Action on Smoking and Health, Cancer Research UK, and the Institute for Tobacco Studies in Stockholm. Sceptics However, another group of US public health researchers remain unconvinced, and suggest, in an accompanying commentary, that the evidence presented in favour of snus is flawed. They say there is little evidence that these products prevent smoking or help smokers to quit. The growth in smokeless tobacco use in both Sweden and the US occurred largely among young men, they say, but smoking in Sweden has been declining rapidly among women and older men.
From BBC News - http://news.bbc.co.uk/2/hi/health/3300769.stm
Study: The Effects of Smokeless Tobacco on Smoking and Public Health Sweden
Excerpts from:Effect of smokeless tobacco (snus) on smoking and public health in Sweden
Snus is manufactured and stored in a manner that causes it to deliver lower concentrations of some harmful chemicals than other tobacco products, although it can deliver high doses of nicotine. It is dependence forming, but does not appear to cause cancer or respiratory diseases. It may cause a slight increase in cardiovascular risks and is likely to be harmful to the unborn fetus, although these risks are lower than those caused by smoking. There has been a larger drop in male daily smoking (from 40% in 1976 to 15% in 2002) than female daily smoking (34% in 1976 to 20% in 2002) in Sweden, with a substantial proportion (around 30%) of male ex-smokers using snus when quitting smoking. Over the same time period, rates of lung cancer and myocardial infarction have dropped significantly faster among Swedish men than women and remain at low levels as compared with other developed countries with a long history of tobacco use.
Conclusions: Snus availability in Sweden appears to have contributed to the unusually low rates of smoking among Swedish men by helping them transfer to a notably less harmful form of nicotine dependence.
View the Entire Study Tobacco Control Online - http://tc.bmjjournals.com/cgi/content/full/12/4/349
Study: Swedish Match Company, Swedish snus and public health: a harm reduction experiment in progress?
The Swedish experience provides a useful conceptual demonstration of the potential benefits of a harm reduction approach that is integrated as part of an overall approach to prevent tobacco use and offer greater access to treatment for dependence. Tobacco attributable mortality in Sweden has declined following the declines of smoking prevalence. The decline in smoking appears to be primarily attributable to increased education about the dangers of tobacco use and the increased availability of treatments for tobacco dependence that have stimulated and supported cessation activity. Cessation is known to reduce disease risks.43 Comprehensive approaches such as are under consideration by the World Health Organization's Tobacco Control Framework Convention process,44 may benefit from evaluation of the Swedish experience because such efforts are intended to reduce tobacco attributed death and disease by more effectively preventing the initiation of use, stimulating and supporting cessation efforts, and reducing the toxicity of the products that are used. This should not be taken to imply that all aspects of the Swedish experience should be promoted or replicated. In particular, we have serious reservations about the promotion or seeming endorsement of any kind of tobacco product by the health community, particularly when pharmaceutical products developed specifically for the treatment of tobacco dependence are becoming increasingly available. We also believe that public health policy developers should be mindful of the complications of approaches that appear to promote any form of tobacco product use because such strategies could undermine prevention and cessation effort just as apparently did the promotion of light cigarettes.2 8 9 We further concur with the US Institute of Medicine report conclusion that such tobacco toxin reduction approaches should be promoted only as part of comprehensive strategies to also promote cessation and prevention of tobacco use.2 Even as we learn from the developments in Sweden we need to monitor further developments because the experiment remains one in progress. The recent acquisition of a major cigar company by Swedish Match,24 25 and its expressed intent to develop and market nicotine gum products and new smokeless tobacco products not for smoking cessation but for those not interested in giving up smoking for reduced smoking and in situations where they cannot smoke,45 46 are tangible signs that the Swedish "experiment" remains in progress. Swedish Match is a publicly held company that has stated that its business developments are intended to provide more shareholder value.24 25 This implies that in the long run, it will need to expand its total business by creating new users for its products. It is sobering that in the USA, efforts of smokeless tobacco companies to grow their business have resulted in substantial increases in smokeless tobacco use among young people and that overall smokeless tobacco consumption increased in the 1970s and 1980s followed by increased cigarette smoking in young people in the 1990s.21 47 Yet another source of caution is that it is even less clear whether any sort of effort to steer a population to smokeless tobacco forms as opposed to cigarettes could or should occur in developing countries in which smokeless forms are already dominant, particularly in light of the probably even greater difficulty of controlling the toxicity of the smokeless products.48 The issues are extraordinarily complex and many of the important factors are outside the practical control of the health community, such as the nature of the competing commercial interests and the population preferences for nicotine intake form.49 As this commentary suggests, many factors determine the overall pattern of nicotine use and resultant health effects. We believe it is interesting and potentially useful to consider how these various forces contribute to differing patterns of product use in Sweden and the USA. As we noted earlier, the present assessment is not a recommendation of the Swedish approach for other countries to attempt to adopt. Nonetheless, we believe that consideration of the impact of the many forces at work in real world "experiments" such as Sweden can be useful as regulatory experts consider policies aimed at reducing the prevalence of tobacco use and tobacco caused death and disease. The experience in Sweden continues to evolve and it will be important to monitor the impact of the activities of Swedish Match, as it attempts to expand its nicotine market, on patterns of nicotine product use and public health.
View the Entire Study Tobacco Control Online - Study