Use of snus and acute myocardial infarction: pooled analysis of eight prospective observational studies
Abstract
The use of snus (also referred to as Scandinavian or Swedish moist smokeless tobacco), which is common in Sweden and increasing elsewhere, is receiving increasing attention since considered a tobacco smoke "potential reduction exposure product". Snus delivers a high dose of nicotine with possible hemodynamic effects, but its impact on cardiovascular morbidity and mortality is uncertain. The aim of this study was to investigate whether snus use is associated with risk of and survival after acute myocardial infarction (AMI). Data from eight prospective cohort studies set in Sweden was pooled and reanalysed. The relative risk of first time AMI and 28-day case-fatality was calculated for 130,361 men who never smoked. During 2,262,333 person-years of follow-up, 3,390 incident events of AMI were identified. Current snus use was not associated with risk of AMI (pooled multivariable hazard ratio 1.04, 95 % confidence interval 0.93 to 1.17). The short-term case fatality rate appeared increased in snus users (odds ratio 1.28, 95 % confidence interval 0.99 to 1.68). This study does not support any association between use of snus and development of AMI. Hence, toxic components other than nicotine appear implicated in the pathophysiology of smoking related ischemic heart disease. Case fatality after AMI is seemingly increased among snus users, but this relationship may be due to confounding by socioeconomic or life style factors.
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In a pooled analysis, there is no association between current snus use and increased risk of acute myocardial infarction (pHR = 1.04, 95% CI: 0.93-1.17); however, among snus users there is an increase in short-term case fatality rate (OR = 1.28; 95% CI: 0.99-1.68).
“no association between current snus use and an increased risk of acute myocardial infarction (AMI) (pooled hazard ratio (pHR) = 1.04, 95% CI: 0.93-1.17).However, among snus users there was an increase in short-term case fatality rate (OR = 1.28; 95% CI: 0.99-1.68)(Hansson et al. 2012).”
From Comparison of the Health Effects Associated with the Use of Snus and Tobacco-Free Oral Nicotine Pouches: A Systematic Review (2026) · cites this paper as Hansson et al. 2012
Cites
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Maternal use of swedish snuff (snus) and risk of stillbirth
Wikström, A.-K., Cnattingius, S., & Stephansson, O. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181f20d7e · Cited by 83 · see citing works
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European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490 · see citing works
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- Authors
- Hansson, J., Galanti, M. R., Hergens, M.-P., Fredlund, P., Ahlbom, A., Alfredsson, L., Bellocco, R., Eriksson, M., Hallqvist, J., Hedblad, B., Jansson, J.-H., Nilsson, P., Pedersen, N., Trolle Lagerros, Y., Östergren, P.-O., & Magnusson, C.
- Venue
- European Journal of Epidemiology
- Published
- 2012-06-22
- Volume
- 27
- Issue
- 10
- Pages
- 771-779
- ISSN
- 0393-2990
- 1573-7284
- Cited by
- 94
- References
- 3
- Language
- en
- Licence
- www.springer.com/tdm (tdm)
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