Vice Squad
Tuesday, May 15, 2007
Snus Alarm?

A friend of Vice Squad directs our attention to a notice in the Health Affairs blog about some articles on snus in this week's Lancet. Snus is the coolly-named four-lettered snuff-like product from Sweden -- is snus the IKEA of tobacco commodities? -- that would lead to a vast improvement in health if switched to by all current smokers (and if no other changes followed, such as diminished desistance or increased uptake of smoking or snus.) But making snus available for harm reduction purposes is a controversial policy, in part because it might legitimate tobacco and perhaps could lead to increased smoking. Further, snus is not perfectly safe in its own right -- there is some evidence that snus increases the risk of pancreatic cancer, for instance. Snus currently is legal in Sweden, but nowhere else within the European Union.

The Lancet articles attempt to put some quantitative markers on the trade-offs around snus use. According to the post at the Health Affairs blog, one of the Lancet articles (I do not yet have access to the originals), calculates that it would take 14 or more current non-smokers to take up snus to offset the health gain from one current smoker switching to snus. (It sounds as if the possibility that snus itself could eventually promote smoking is left out of the calculation, though.) In any event, the new articles do not appear to change what Vice Squad has considered to be the standard snus story, namely, that smoking is so bad for health that snus is likely to offer an attractive option to reduce total tobacco-related harms. Snus should be especially attractive (and I believe made available) to people who have been foiled in multiple attempts to quit smoking; I am not much of a fan of reducing the options to "quit" or "die" for those smokers with a demonstrated difficulty in quitting when there's a third alternative.

The most recent prior snus-posting at Vice Squad appeared on March 29, 2007.

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