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From a perspective of public health, there is much to say about Swedish snus and its positive influence. An increasing amount of scientific studies, regarding the positive health aspects of the unique Swedish snus, has lately been highlighted in the media and through various interest organisations. At the same time, the international interest concerning Swedish snus is growing steadily, specifically as a more healthy alternative to traditional tobacco use, primarily smoking.
Today, Swedish snus is the most common smoking cessation aid in both Sweden and Norway. Due to that fact there are medical researchers whom states that Swedish snus has a considerable positive effect in regards to public health. This is evidently noticeable in Scandinavian countries such as Sweden and Norway, where there are more snus users than smokers. An example of this, often worth mentioning in this context, is that Sweden has the lowest amount of lung cancer incidence and mortality within Europe, according to the WHO's International Agency for Research on Cancer (IARC) and World Health Ranking statistics, despite the fact that the total amount of tobacco users are in parity with other countries. This is primarily due to the fact that Swedish snus, which is produced through a process very similar to pasteurization, contains very low amounts of TSNA (Tobacco Specific Nitros Amines), which are the main group of cancerogenic substances in tobacco, as well as the fact that the delivery of nicotine does not occur through harmful smoke being transported via the windpipe down to the lungs.
New scientific studies, as well as reviewed analysis of earlier scientific investigations, has shown a lack of evidence in order to connect Swedish snus specifically to such medical states of disease that are usually considered to be caused by other kinds of tobacco use, primarily smoking, such as lung cancer, cardiovascular disease, stroke and various diseases and infections to the respiratory organs (WHO 2014). All use of nicotine are however addictive, even substitutes such as nicotine gums and nicotine patches.
Furthermore, the use of Swedish snus does not cause any secondary or peripheral injuries to the close environment, as passive tobacco smoking have been known to do for a long time. In 2014 the U.S. Department of Health determined that passive smoking increases the risk for lung cancer and cardiovascular disease for adults as well as for children. It is also established that tobacco smoke in relation to pregnancy increases the risk for inhibited fetal growth, low birth weight and premature birth. Pregnant women are however recommended to refrain from all sorts of nicotine use.
For further reading on Swedish snus and Health, please see the following reports in PDF-format:
Swedish Snus Report October 2015 (121 kB - English only)
Environ - Review of the Scientific Literature on Snus (1,5 MB - English only)
"Swedish Snus benefits public health"
Aftonbladet, Sweden, 29 September 2013:
The scientific community agrees that Swedish Snus is less harmful than other tobacco products. In an article published in the international magazine Drugs and Alcohol Today, Dr. Karl Erik Lund, chief researcher at ‘Statens Institutt for Rusmiddelforskning’ (SIRUS) in Norway, presents new observations.
- We have been studying the impact of Swedish snus in regards to public health during many years. At this point we can establish the fact that Swedish snus contributes explicit gains to the health status of the population. This also applies to Sweden, Dr. Karl Erik Lund says to Aftonbladet.
According to the scientific report, the use of Swedish snus have not resulted in double addiction, where people both smokes and uses snus. The consequences of the Anti-Snus lobby activities may prove lethal, according to Dr. Karl Erik Lund.
- The focus on a tobacco free society may stand in the way of using Swedish snus as a harm reducing means. We might not be able to state how many lives has been won thanks to Swedish snus, but in all it indicates that Swedish snus have a positive effect on public health, says Dr. Karl Erik Lund.
”Smoking is the villain.”
Dagens Medicin Magazine, published 24 March 2016. Debate article:
”We can establish that nicotine in itself probably does not constitute any major health hazard. It is smoking that is the villain when it comes to chronic obstructive lung disease and lung cancer.”
Dr. Stefan Willers, chief physician, associate professor Lung- and allergy unit, Lund University, Sweden.
”No Connection to Head and Neck Cancer.”
Interview statement, May 2020:
”A large proportion, perhaps as much as 20 %, of the Swedish population use Swedish snus, regularly. And there is yet to see any head and neck cancer patients where we can see a direct connection with the use of Swedish snus and cancer. I also know of several scientific studies... where they have tried to establish connections to head and neck cancer and Swedish snus and the conclusion have always been that they can not find such a connection.”
Dr. Thomas Westin, associate professor, Sahlgrenska University Hospital, Sweden, former clinical director at the Head and neck cancer unit, Royal Hallamsire Hospital, UK.
Within the boundaries of international research concerning tobacco consumption there is an expressed established paradox, known within the scientific community as "The Swedish Experience". According to Swedish Match, everything centres around the statistic fact that asserts that ”the risk of dying in a tobacco related disease is less in Sweden than in any other European country, despite that the tobacco consumption is on a comparable level with other countries in Europe, measured in kilograms.
”The Swedish Experience” can, according to Swedish Match, probably be explained by the circumstance that the unique Swedish snus constitutes a large part of Swedish men's tobacco consumption, even though the total tobacco consumption is about the same as in other comparable countries. The major difference thus comes from the fact that Swedish men doesn't smoke to the same extent, but uses Swedish snus instead. Statistics brought forward by Swedish Match also shows that the proportion of Swedish men that uses snus amounts to 18%, while the share of daily smokers amounts to 10%, which moreover is the lowest number in Europe.
As previously established, this results in a very low rate of tobacco related diseases and thus also a very low mortality rate related to smoking amongst Swedish men. ”This unique relationship is documented in a large number of epidemiological studies that, among other things, shows that people in Sweden has the lowest risks of contracting lung cancer among the industrialized countries.” According to Swedish Match, the use of Swedish snus may perhaps not entirely be disclaimed from any negative health effects, but scientific results has shown that the health risks of using Swedish snus are considerably less than from smoking. They exemplify these results with the following facts concerning the use of Swedish snus:
References:
1. Sverige: Statens Folkhälsoinstitut. Norge: Sosial- og helsedirektoratet. Danmark: Sundhedsstyrelsen. Europa (EU 25+ Island, Norge och Schweiz): The European Tobacco Control Report 2007. WHO Regional Office for Europe.
2. Folkhälsa. Lägesrapport 2005, sid 24-25. Socialstyrelsen
3. Tobacco Statistics 1970-1999. Statistical Report 2000-09-18, VECA HB Statistical Bureau, p. 12.
4. Peto, R.; Lopez, AD.; Boreham, J.; Thun, M.; Heath, C. Mortality from smoking in developed countries 1950-2000 (2nd edition). Oxford, Oxford University Press; 2003. Updated in June 2006.
5. Swedish Cancer Registry, 1998.
6. Lewin, F., Norell, S.E., Johansson, H., Gustavsson, P., Wennerberg, J., Björklund, A., Rutqvist, L.E. Smoking tobacco, oral snuff, and alcohol in the etiology of squamous cell carcinoma of the head and neck. Cancer, 82, 1367-75 (1998).
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8. Ye, W., Ekström, A.M., Hansson, L.-E., Bergström, R., Nyrén, O. Tobacco, alcohol and the risk of gastric cancer by sub-site and histologic type. Int. J. Cancer, 83, 223-9 (1999).
9. Lagergren, J., Bergström, R., Lindgren, A., Nyrén, O. The role of tobacco, snuff and alcohol use in the aetiology of cancer of the oesophagus and gastric cardia. Int. J. Cancer, 85, 340-6 (2000).
10. Bolinder, G., Alfredsson, L., Englund, A., de Faire, U. Smokeless tobacco and increased cardiovascular mortality among Swedish construction workers. Am. J. Public Health, 84, 399-404 (1994).
11. Huhtasaari, F., Lundberg, V., Eliasson, M., Janlert, U., Asplund, K. Smokeless tobacco as a possible risk factor for myocardial infarction: A population-based study in middle-aged men. J. Am. Coll. Cardiol., 34, 1784-90 (1999).
12. Eliasson, M., Lundblad, D., Hägg, E. Cardiovascular risk factors in young snuff-users and cigarette smokers. J. Int. Med., 230, 17-22 (1991).