- Tuesday, 25 February 2014 15:05
Snus use NOT associated with an elevated risk for stroke
By Dr Farsalinos
Although this issue is not directly related to e-cigarettes, it is important to check the data coming from epidemiological studies of other alternative-to-smoking products. This can give us an idea on what to expect from long-term e-cigarette use, although I should stress that this is indirect information and in no way can it be considered as proof for e-cigarette use outcomes. Snus, a form of smokeless tobacco that is still banned in the European Union for unknown reasons, has been long used in Scandinavian countries, especially by males. I remind you that Sweden has by far the lowest rate of lung cancer incidence compare to any other European Country. The latest study evaluated the effects of snus use on the incidence of stroke.
Researchers analyzed 8 prospective cohort studies. A large number of never-smokers (more than 130,000) were included in these studies; more than 32,000 of them were snus users. Overall, they found that the risk of stroke is not elevated by snus use. Even after checking for specific stroke subtypes (hemorrhagic or thrombotic), no elevation of risk was found. Importantly, the comparison was made between snus users and non-users, with both groups NEVER being smokers in the past. The only negative finding of this study was that in those who suffered a stroke, the risk of death was higher for snus users compared to non-users. The authors concluded that nicotine is not the factor associated with development of stroke because although snus and smoking deliver similar levels of nicotine, the risk of stroke is not elevated by snus use but is greatly elevated after smoking.
The study is very important and adds to current evidence suggesting that snus use has little contribution to the development of cardiovascular disease. I need to stress that in this study the comparison was made between two groups that were never smokers. Therefore, it is expected that switching from smoking to snus use will be highly beneficial. We expect similar findings to come up from e-cigarette use, but we need to wait for several years before we have any hard evidence for this. Are the regulators reading any scientific documents?