Effect of smokeless tobacco (snus) on smoking and public health in Sweden
Open accessAbstract
OBJECTIVE: To review the evidence on the effects of moist smokeless tobacco (snus) on smoking and ill health in Sweden. METHOD: Narrative review of published papers and other data sources (for example, conference abstracts and internet based information) on snus use, use of other tobacco products, and changes in health status in Sweden. RESULTS: Snus is manufactured and stored in a manner that causes it to deliver lower concentrations of some harmful chemicals than other tobacco products, although it can deliver high doses of nicotine. It is dependence forming, but does not appear to cause cancer or respiratory diseases. It may cause a slight increase in cardiovascular risks and is likely to be harmful to the unborn fetus, although these risks are lower than those caused by smoking. There has been a larger drop in male daily smoking (from 40% in 1976 to 15% in 2002) than female daily smoking (34% in 1976 to 20% in 2002) in Sweden, with a substantial proportion (around 30%) of male ex-smokers using snus when quitting smoking. Over the same time period, rates of lung cancer and myocardial infarction have dropped significantly faster among Swedish men than women and remain at low levels as compared with other developed countries with a long history of tobacco use. CONCLUSIONS: Snus availability in Sweden appears to have contributed to the unusually low rates of smoking among Swedish men by helping them transfer to a notably less harmful form of nicotine dependence.
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Swedish snus differs from other types of snuff products as it contains lower levels of harmful substances.
“Swedish snus differs from other types of snuff products as it contains lower levels of harmful substances [17], [18].”
From The effect of swedish snuff (snus) on offspring birthweight: a sibling analysis (2013) · cites this paper as [17]
Snus provides a unique opportunity to eliminate the effect of combustion and, to some extent, isolate the effect of nicotine on birthweight in an observational representative study.
“However, snus provides a unique opportunity to eliminate the effect of combustion and, to some extent, isolate the effect of nicotine (with similar levels to those of smoked tobacco) on birthweight in an observational representative study.”
From The effect of swedish snuff (snus) on offspring birthweight: a sibling analysis (2013) · cites this paper as [17]
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“Swedish oral snuff, or ‘‘snus’’, contains similar or higher levels of nicotine and lower levels of tobacco specific nitrosamines than cigarettes and American snuff, and its use as a harm reduction drug for smoking cessation is internationally debated [8–10] [11–13].”
BackgroundThe effect of swedish snuff (snus) on offspring birthweight: a sibling analysis
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- Authors
- Foulds, J., Ramstrom, L., Burke, M., & Fagerström, K.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- University of Medicine and Dentistry of New Jersey (US)
- Corresponding author
- Foulds, J
- Venue
- Tobacco Control
- Publisher
- BMJ
- Published
- 2003-12
- Volume
- 12
- Issue
- 4
- Pages
- 349-359
- ISSN
- 0964-4563 (ISSN-L)
- 1468-3318
- PMC
- PMC1747791
- OpenAlex
- W2156436325
- Cited by
- 471
- References
- 61
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 11 · 2023: 15 · 2022: 16 · 2021: 8 · 2020: 16 · 2019: 22 · 2018: 19 · 2017: 20 · 2016: 25 · 2015: 28 · 2014: 26 · 2013: 28 · 2012: 26
- FWCI
- 12.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Tobacco Control (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- State of New Jersey Department of Health
- Missouri Department of Health and Senior Services
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- snus, nicotine dependence, smoking cessation, tobacco harm, lung cancer, myocardial infarction, cardiovascular risk, fetal risk, sex differences in smoking
- MeSH terms
- Adult, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Neoplasms, Nicotine, Pregnancy, Pregnancy Complications, Risk Factors, Smoking, Sweden, Tobacco Use Disorder, Tobacco, Smokeless
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