Effects on health of switching from cigarettes to snus

A review on the health effects of snus was recently published (online first) in Regulatory Toxicology and Pharmacology Jounal. Interestingly, in this review and meta-analysis, author (P.N. Lee) compared the risk for cancer and cardiovascular disease between current smokers who have never used snus (“continuers”), ex-smokers who have never used snus (“quitters”) and ex smokers who have switched to snus (“switchers”). Two studies on oral and gastric cancer and 4 studies on cardiovascular disease were analyzed. The metanalysis showed that “switchers” had a 45% reduction in risk for cancer or cardiovascular disease compared to current smokers (“continuers”). Even more interestingly, no difference in risk was found between “switchers” and “quitters” (those who had quit smoking without using snus).

This study once again confirms that snus is an important tobacco harm reduction product which significantly lowers the risk of smoking-related disease. Moreover, it was found to produce benefits similar to quitting smoking without using any tobacco alternative. Despite this and other evidence showing minimal (if any) health impact of using smokeless tobacco like snus, the European Commission is once again proposing a ban on these products in their new Tobacco Directive proposal.

Note: this study was supported by grands from Altria, and the author has been a long-time consultant to tobacco industry. I am not implying that the study was biased because of this, I just think that it should be mentioned.

                                                                                Dr Konstantinos Farsalinos

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