Compared to smokers who became persistent users, experimenters were less likely to find snus to be an effective means to relieve negative affect, cravings, or control weight. Similarly, in head-to-head product comparisons, more experimenters than persistent users preferred cigarettes over snus as it pertains to cravings and ease of use. These results overlap with research showing many smokers are unable to fully substitute snus for cigarettes, even when explicitly asked to do so.
In sum, experimenters reported fewer positive reactions to snus than persistent users potentially explaining their discontinuation of use ; however, overall smokers reported that snus was a poor substitute for their cigarettes. Somewhat consistent with these results, a previous study of Norwegian adolescents showed that males perceived cigarettes and snus as less harmful than females did.
We did not further examine differences between perceptions of products as a function of gender as it is beyond the scope of this paper.
This study has several limitations worth noting. First, we cannot make a direct comparison between snus use in this US-based study and other countries eg, Scandinavian countries. Third, the study was limited to smokers who were uninterested in quitting, and therefore, the results should not be generalized to all smokers. Making this message clearer, which can be more easily done under different regulatory constraints, may have increased experimentation.
These limitations are offset by study strengths, including a novel design of a longitudinal assessment of naturalistic use, among a group of unmotivated to quit smokers. In conclusion, while several Scandinavian countries have experienced successful reduction in smoking prevalence and smoking-related illness, likely as a function of widespread snus use, this trend has not replicated in the United States.
The present study provides further insight into low uptake of snus in the United States. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
KMC has received grant funding from the Pfizer, Inc. He also receives funding as an expert witness in litigation filed against the tobacco industry.
The authors would like to acknowledgement the work of the many research assistants who contributed to the conduct of this study, primarily Amy Boatright, Nichols Mabry, Easha Tiwari, and Caitlyn Hood. Evaluation of carcinogen exposure in people who used reduced exposure tobacco products. J Natl Cancer Inst. Google Scholar. New and traditional smokeless tobacco: comparison of toxicant and carcinogen levels.
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Relative harm of snus and cigarettes: what do Norwegian adolescents say? Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Similar products to snus are traditionally used around the world, but they vary greatly in nicotine and other chemical content.
The use of snus is controversial. The European Union has banned its sale except for in Sweden because of the known addictive and harmful effects of nicotine. Plus, snus advocates say, it helps people stop smoking. They point to the public health benefits of snus use in Sweden. Specifically, the smoking rate dropped dramatically in Sweden as more men switched to snus use. According to a review in the BMJ journal Tobacco Control, 40 percent of males smoked daily in , compared with 15 percent in At the same time, the researchers found that there have been reductions in lung cancer, cardiovascular disease, and deaths from other causes in Sweden.
Whether snus causes cancer is a complex question to sort out scientifically. Study results are bewilderingly diverse. Some studies find a specific cancer risk connected to snus use, and other studies find the opposite. Some research studies lump all smokeless tobacco products together. Others are limited to snus use in Swedish populations. Smoking is known to be a high risk factor for pancreatic cancer. A meta-analysis of 82 different studies found that the increased risk of pancreatic cancer for current smokers was 74 percent.
The increased risk for former smokers was 20 percent. Does the risk remain the same with smokeless tobacco? Two studies that included snus specifically found a moderate risk increase. Two other studies found no association. The study concluded that use of Swedish snus should considered a possible risk factor for pancreatic cancer. The most recent and largest study , reported in , involved a large sample of , males in Sweden. This included nonusers and users of snus.
The study authors noted that their findings may be related to the lower nitrosamine levels in Swedish snus than in tobacco smoke. They also suggested that the increased risk of pancreatic cancer in tobacco smokers is related to the carcinogens involved with combustion.
Tobacco smoking is one of the strongest risk factors for oral cancers. Evidence for snus leading to oral cancers is mixed. A study , which included snus products from different countries, made a stronger conclusion: that there is a strong link between smokeless tobacco use and cancers of the cheek and gums.
The study noted that the previous data on smokeless tobacco and oral cancers was sparse. A study of , Swedish construction workers who used snus but were previously nonsmokers concluded that there was no increased risk of oral cancers in snus users. Note that this is the same study that found an increased risk of pancreatic cancer in the same population.
Another Swedish study differed. This case report of 16 Swedish men with oral squamous cell cancers concluded that Swedish snuff might not be a harmless alternative to smoking. These men had used snus prior to cancer diagnosis for a mean of The cancers were in the sites where they had placed snus.
A similar warning came from a long-term study of 9, Swedish snus-using men. It found a high incidence of oral, pharyngeal, and overall total smoking-related cancer in the snus users studied. An independent report was commissioned by leading Swedish snus producer Swedish Match. It comments on the characteristic type of mouth lesion that snus users may get. Imagine my surprise to unwrap my Sunday paper one day last month and find inside a clever advertising pamphlet and a card good for a free tin of Camel Snus pronounced "snoose" , R.
Reynolds' new flavored spitless chewing tobacco. And Reynolds is not alone: Phillip Morris is also testing snus products. Never heard of it? Camel Snus was recently test marketed in Portland, Oregon, and Austin, Texas, and the test has now spread to eight cities.
Camel Snus is a dime-sized pouch of powdered chew tobacco, packaged in tins of
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