Thursday, March 29, 2007
A report (129-page pdf here) has just been released that reviews previous research on the health effects of snus, the smokeless tobacco product popular in Sweden. The main finding of the report coheres with the standard wisdom, that snus use is much less dangerous than smoking, which is not to say that snus is perfectly safe. There is one outlier piece of research in the review, which was sponsored (that is, the newly-released review was sponsored) by the New Zealand Ministry of Health, indicating that snus use by construction workers in the 1970s led to significantly greater cardiovascular disease and overall mortality, though many subsequent studies failed to replicate that finding. The anomaly might be explained in part by a move to milder snus over time. Another point stressed by the report is that we still are quite unsure about the health effects of long-term snus use.
The review is careful when it looks (pages 79-81) at whether the promotion of snus will lead to lower aggregate harms to health. Surely any current smoker who fully switches to snus is better off, assuming that he or she would have continued to smoke in the absence of snus. But among the complicating factors are that perhaps switching to snus prevents a cessation of tobacco use that otherwise would have occurred, or snus might be used as a supplement to smoking. Further, some people might initiate tobacco use via snus and then migrate to cigarettes. Nevertheless, if snus really holds as little risk to health as it appears to hold, then its introduction is almost sure to reduce negative health effects in the short to medium term.