CoChat
Sign Up
Cited by 92

Long‐term use of Swedish moist snuff and the risk of myocardial infarction amongst men

Hergens, M.‐P., Alfredsson, L., Bolinder, G., Lambe, M., Pershagen, G., Ye, W.·2007·Journal of Internal Medicine
DOI 10.1111/j.1365-2796.2007.01816.x
Open this paper in CoChat — free account

Abstract

Abstract.: Background. The scientific evidence on cardiovascular risks associated with long‐term use of snuff is limited and inconclusive. The use of this smokeless tobacco has increased in recent decades, and adverse health effects associated with snuff use could be of great public health concern. Objective. We aimed to study whether long‐term use of snuff affects the risk of myocardial infarction. Design. Between 1978 and 1993 all construction workers in Sweden were offered repeated health check‐ups by the Swedish Construction Industry's Organization for Working Environment Safety and Health. A cohort was created with information on tobacco use and other risk factors, collected through questionnaires. Setting. In total, 118 395 nonsmoking men without a history of myocardial infarction were followed through 2004. Information on myocardial infarction morbidity and mortality was obtained from national registers. Relative risk estimates were derived from Cox proportional hazards regression model, with adjustment for age, body mass index and region of residence. Results. Almost 30% of the men had used snuff. In total, 118 395 nonsmoking men without a history of myocardial infarction were followed through 2004. The multivariable‐adjusted relative risks for ever snuff users were 0.91 (95% confidence interval, 0.81–1.02) for nonfatal cases and 1.28 (95% confidence interval, 1.06–1.55) for fatal cases. Heavy users (≥50 g day−1) had a relative risk of fatal myocardial infarction of 1.96 (95% confidence interval, 1.08–3.58). Snuff use increased the probability of mortality from cardiovascular disease amongst nonfatal myocardial infarction patients. Conclusion. Our results indicate that snuff use is associated with an increased risk of fatal myocardial infarction.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/j.1365-2796.2007.01816.x

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Among never smoking snus users compared to never-users, there are lower adjusted relative risks for nonfatal myocardial infarction (aRR = 0.91; 95% CI: 0.81-1.02) and increased adjusted relative risk for fatal myocardial infarction (aRR = 1.28; 95% CI: 1.06-1.55).

    “lower adjusted relative risks (adjusted risk ratio (aRR) = 0.91; 95% CI: 0.81-1.02)for nonfatal cases and increased adjusted relative risk (aRR = 1.28; 95% CI: 1.06-1.55)for fatal cases of myocardial infarction (MI) among never smoking snus users compared to never-users (Hergens et al. 2007).”

    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 Hergens et al. 2007

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 31

  1. Holm H, Jarvis MJ, Russell MA, Feyerabend C. Nicotine intake and dependence in Swedish snuff takers. Psychopharmacology (Berl) 1992; 108: 507-11.
  2. Fant RV, Henningfield JE, Nelson RA, Pickworth WB. Pharma- cokinetics and pharmacodynamics of moist snuff in humans. Tob Control 1999; 8: 387-92.
  3. Westman EC. Does smokeless tobacco cause hypertension? South Med J 1995; 88: 716-20.
  4. Rohani M, Agewall S. Oral snuff impairs endothelial function in healthy snuff users. J Intern Med 2004; 255: 379-83.
  5. Bolinder G, de Faire U. Ambulatory 24-h blood pressure monit- oring in healthy, middle-aged smokeless tobacco users, smokers, and nontobacco users. Am J Hypertens 1998; 11: 1153-63.
  6. Bolinder GM, Ahlborg BO, Lindell JH. Use of smokeless tobacco: blood pressure elevation and other health hazards found in a large-scale population survey. J Intern Med 1992; 232: 327-34.
  7. Bolinder G, Noren A, Wahren J, De Faire U. Long-term use of smokeless tobacco and physical performance in middle-aged men. Eur J Clin Invest 1997; 27: 427-33.
  8. Eliasson M, Lundblad D, Hagg E. Cardiovascular risk factors in young snuff-users and cigarette smokers. J Intern Med 1991; 230: 17-22.
  9. Siegel D, Benowitz N, Ernster VL, Grady DG, Hauck WW. Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players. Am J Public Health 1992; 82: 417-21.
  10. Bolinder G, Alfredsson L, Englund A, de Faire U. Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers. Am J Public Health 1994; 84: 399-404.
  11. Henley SJ, Thun MJ, Connell C, Calle EE. Two large prospect- ive studies of mortality among men who use snuff or chewing tobacco (United States). Cancer Causes Control 2005; 16: 347-58.
  12. Huhtasaari F, Asplund K, Lundberg V, Stegmayr B, Wester PO. Tobacco and myocardial infarction: is snuff less dangerous than cigarettes? BMJ 1992; 305: 1252-6.
  13. 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 1999; 34: 1784-90.
  14. Hergens MP, Ahlbom A, Andersson T, Pershagen G. Swedish moist snuff and myocardial infarction among men. Epidemiol- ogy 2005; 16: 12-16.
  15. Rosen M, Alfredsson L, Hammar N, Kahan T, Spetz CL, Ysberg AS. Attack rate, mortality and case fatality for acute myocardial infarction in Sweden during 1987-95. Results from the national AMI register in Sweden. J Intern Med 2000; 248: 159-64.
  16. Korn EL, Graubard BI, Midthune D. Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Am J Epidemiol 1997; 145: 72-80.
  17. Eliasson M, Asplund K, Evrin PE, Lundblad D. Relationship of cigarette smoking and snuff dipping to plasma fibrinogen, fi- brinolytic variables and serum insulin. The Northern Sweden MONICA Study. Atherosclerosis 1995; 113: 41-53.
  18. Tucker LA. Use of smokeless tobacco, cigarette smoking, and hypercholesterolemia. Am J Public Health 1989; 79: 1048-50.
  19. Bolinder G, Noren A, de Faire U, Wahren J. Smokeless tobacco use and atherosclerosis: an ultrasonographic investigation of carotid intima media thickness in healthy middle-aged men. Atherosclerosis 1997; 132: 95-103.
  20. Benowitz NL, Porchet H, Sheiner L, Jacob P Jr. Nicotine absorption and cardiovascular effects with smokeless tobacco use: comparison with cigarettes and nicotine gum. Clin Pharma- col Ther 1988; 44: 23-28.
  21. Yashima M, Ohara T, Cao JM et al. Nicotine increases ventric- ular vulnerability to fibrillation in hearts with healed myocardial infarction. Am J Physiol Heart Circ Physiol 2000; 278: H2124- 33.
  22. Ohara T, Yashima M, Hamzei A et al. Nicotine increases spatio- temporal complexity of ventricular fibrillation wavefront on the epicardial border zone of healed canine infarcts. J Cardiovasc Pharmacol Ther 1999; 4: 121-7.
  23. Mehta MC, Jain AC, Mehta A, Billie M. Cardiac arrhythmias following intravenous nicotine: experimental study in dogs. J Cardiovasc Pharmacol Ther 1997; 2: 291-8.
  24. Benowitz NL. Sodium intake from smokeless tobacco. N Engl J Med 1988; 319: 873-4.
  25. Rodu B, Jansson C. Smokeless tobacco and oral cancer: a review of the risks and determinants. Crit Rev Oral Biol Med 2004; 15: 252-63.
  26. Rundlo ¨f T, Olsson E, Wiernik A et al. Potential nitrite scaven- gers as inhibitors of the formation of N-nitrosamines in solution and tobacco matrix systems. J Agric Food Chem 2000; 48: 4381-8.
  27. Rouse BA. Epidemiology of smokeless tobacco use: a national study. NCI Monogr 1989; 8: 29-33.
  28. Schei E, Fonnebo V, Aaro LE. Use of smokeless tobacco among conscripts: a cross-sectional study of Norwegian army conscripts. Prev Med 1990; 19: 667-74.
  29. Wickholm S, Galanti MR, Soder B, Gilljam H. Cigarette smo- king, snuff use and alcohol drinking: coexisting risk behaviours for oral health in young males. Community Dent Oral Epidemi- ol 2003; 31: 269-74.
  30. Rimm E. Alcohol and cardiovascular disease. Curr Atheroscler Rep 2000; 2: 529-35.
  31. Donaldson SI, Dent CW, Sussman S, Stoddard JL, Severson HH. The organizational implications of smokeless tobacco use in the lumber mill industry. Addict Behav 1996; 21: 259-67.

Cited by

Sorted by citations

Authors
Hergens, M. ‐., Alfredsson, L., Bolinder, G., Lambe, M., Pershagen, G., & Ye, W.
Venue
Journal of Internal Medicine
Publisher
Wiley
Published
2007-06-26
Volume
262
Issue
3
Pages
351-359
ISSN
  • 0954-6820
  • 1365-2796
DOI
10.1111/j.1365-2796.2007.01816.x
Cited by
92
References
1
Language
en
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review