Snus

From Wikipedia, the free encyclopedia

Jump to: navigation, search
 This article is missing citations or needs footnotes. Please help add inline citations to guard against copyright violations and factual inaccuracies. (April 2008)
Portioned snus of the Swedish label General.

Snus (IPA: /snuːs/) is a moist powder tobacco product that is consumed by placing it under the lip for extended periods of time. It is a form of snuff that is used in a manner similar to American dipping tobacco, but typically does not result in the need for spitting. Snus is also unique in that it is steam-cured rather than fire-cured, is not fermented and contains no added sugar. The sale of snus is illegal in the European Union[1][2], but due to exemptions, it is still manufactured and consumed primarily in Sweden and Norway.

Contents

[edit] Types

Lössnus of the Swedish label Skruf, and a typical cylindrical Norwegian shaped pris.

There are two main types of snus on the market:

  • originalsnus or lössnus is a loose, moist powder which can be portioned and packed into a cylindrical or spherical shape with the fingertips or snusportioner. The end result is often referred to as a pris (pinch) or prilla or prell (slang for pris).
  • portionssnus, is prepackaged powder in small bags made from the same material as teabags. It comes in smaller quantities than the loose powder but is considered easier to handle (and expectorate) than the loose powder.

Swedish snus is made from air dried tobacco from various parts of the world. In earlier times tobacco for making snus used to be laid out for drying in Scania and Mälardalen. Later Kentucky tobaccos were used. The ground tobacco is mixed with water, salt, sodium carbonate and aroma and is prepared through heating, generally via steam. Moist snus contains more than 50% water, and the average use of snus in Sweden is approximately 800 grams (16 units) per person each year. 12% (1.1 million people) of the population in Sweden use snus[1]. Unlike American-sold oral tobacco, snus has not gone through a fermentation process.

Snus is sold mainly in Sweden and Norway,and is being trialed in South Africa and the United States. It can be found in various places frequented by Scandinavian tourists like Murmansk in Russia (with the notable exception of countries in the EU; see below). It is sold in small tins, which in the earlier years were made of porcelain, wood, silver or gold. At the time of writing, portioned snus usually comes in plastic tins of 24g, while loose snus is mostly sold in compressed paper tins with plastic lids, at 45g (50g before 2008).

Portioned snus is most commonly sold in three different variants, namely mini, normal/large and maxi. The weights may vary, but the most sold snus labels share their weight. Mini portions weigh 0.5g, with 20 pieces per tin. Standard portions weigh 1g, with 24 portions per tin, and maxi portions weigh 1.7g, with 17 pieces per tin.

The price for the 45g product is approximately €3-5 in Sweden and €7.50 in Norway as Norwegian taxes are higher.

[edit] Usage and storage

The common way to consume snus is to place it beneath the upper lip, and keep it there for a time varying from a few minutes to several hour. Snus should be stored refrigerated or frozen to minimize the formation of nitrosamines.[citation needed]

[edit] Health consequences

Since snus is not intended nor recommended for inhalation, it does not affect the lungs as cigarettes do, although it does contain more nicotine than cigarettes. Because it is steam-cured, rather than fire-cured like smoking tobacco or other chewing tobacco, it contains lower concentrations of nitrosamines and other carcinogens that form from the partially anaerobic heating of proteins; 2.8 parts per mil for Ettan brand compared to as high as 127.9 parts per mil in American brands, according to a study by the Commonwealth of Massachusetts Department of Health.[citation needed] The World Health Organization (WHO) acknowledges that Swedish men have the lowest rate of lung cancer in Europe, partly due to the low tobacco smoking rate, but does not argue for substituting snus for smoking, citing that the effects of snus still remain unclear. Around 2005 several reports pointed to the fact that no carcinogenic effects could be attributed to Nordic snus and this resulted in the warning label that snus could cause cancer could be removed. It was replaced with the more neutral label "Can affect your health negatively". Research is still going on but at the moment no conclusive reports have been made regarding the health effects of snus.

The European Union banned the sale of snus in 1992, after a 1985 WHO study concluded that "oral use of snuffs of the types used in North America and western Europe is carcinogenic to humans", but a WHO committee on tobacco has also acknowledged that evidence is inconclusive regarding health consequences for snus consumers.[citation needed] Only Sweden and EFTA-member Norway are exempt from this ban. A popular movement during the run-up to the 1994 referendum for Sweden's EU membership made exemption from the EU criminalization of snus a condition of the membership treaty. This may be due to taxation reasons.

Recent actions by many European governments to limit the use of cigarettes has led to calls to lift the ban on snus, as it is generally considered to be less harmful than cigarette smoke, both to the user[citation needed] and to others.

[edit] Debate among public health researchers

There is some debate among public health researchers over the use of "safer" tobacco or nicotine delivery systems, generally dividing along two lines of thought. Most researchers are currently of the "abstinence" belief, believing that no form of tobacco or nicotine use is acceptable or safe, and should be minimized among the population. A minority (primarily in the European Union and Canada) believes in "harm reduction," where the belief is generally that, while it should remain a goal to reduce addiction to nicotine in the population as a whole, the reduction of harm to the health of those who choose to use nicotine should override the need to reduce overall nicotine addiction. For example, some research[2] available today shows that snus use reduces or eliminates the risk of cancers that afflict other users of tobacco products such as "chewing tobacco" (the type primarily used in the United States and Canada, created in a process similar to cigarette tobacco) and cigarettes. It is hypothesized that the widespread use of snus by Swedish men (estimated at 30% of Swedish male ex-smokers), displacing tobacco smoking and other varieties of snuff, is responsible for the incidence of tobacco-related mortality in men being significantly lower in Sweden than any other European country; in contrast, since women traditionally are less likely to use snus, their rate of tobacco-related deaths in Sweden can be compared to that of other European countries.

Snus may be less harmful than other tobacco products; according to Kenneth Warner, director of the University of Michigan Tobacco Research Network,

"The Swedish government has studied this stuff to death, and to date, there is no compelling evidence that it has any adverse health consequences. ... Whatever they eventually find out, it is dramatically less dangerous than smoking." [3]

Ongoing discussion and debates among primary scientific researchers of the effects of snus use on life expectancy appears to indicate that there is a significant increase in life expectancy among persons who previously smoked tobacco and switch to Swedish snus, depending on the age of the persons who switch, even when it is assumed that 100% of the risk of cardiovascular diseases among smokers transfers to snus users. [3] It is also noted, in the correspondence seen in the previous citation[4][5] that concerns about the effect of marketing by the tobacco industry, as influenced by the results of these scientific studies, is of primary concern to many researchers in the field, including the risk of emboldening the industry to attempt to increase snus sales among young people and promote dual-use of snus and smoked tobacco, and that the use of medical nicotine, rather than snus, can better target at-risk populations, given better access and pricing.

Opponents of snus sales maintain that, nevertheless, even the low nitrosamine levels in snus cannot be completely risk free, but snus proponents point out that inasmuch as snus is used as a substitute for smoking or a means to quit smoking, the net overall effect is positive, similar to the effect of nicotine patches, for instance.[citation needed]

In addition, rather obviously, this eliminates any exposure to second-hand smoke, further reducing possible harm to other non-tobacco users. This is seen by public health advocates who believe in "harm reduction" as a reason for recommending snus in addition to other nicotine replacement therapies rather than continued use of cancer-causing nicotine delivery systems.

This does not, however, eliminate any harm to health caused by the nicotine itself. Current research focuses on possible long-term effects on blood pressure, hypertension and possible risk of pancreatic cancer due to tobacco-specific nitrosamines (TSNAs). TSNAs are the only component of tobacco shown to induce pancreatic cancer in laboratory animals.[6] Nicotine may also exacerbate pancreatic illness, because nicotine stimulates the gastrointestinal tract's production of cholecystokinin, which stimulates pancreatic growth and may be implicated in pancreatic cancer. Thus far the evidence specifically implicating snus in pancreatic cancer is only suggestive.[7][8] It should also be noted that the probability of developing pancreatic cancer from cigarettes is higher than the suggested chance of developing pancreatic cancer from snus.[9][10] The effects of Swedish snus on blood pressure has been studied at Umeå University in a randomly selected population sample of 4,305 Swedish men between 25 and 74 years of age. In the study, published in November 2008, the researchers found no elevation of blood pressure in snus users who had never been smokers compared to non tobacco users. In fact, snus users had lower systolic blood pressure than non tobacco users in the unadjusted data.[11]

[edit] References

  1. ^ Gray N (September 17–23, 2005). "Mixed feelings on snus". Lancet 366 (9490): 966–7. doi:10.1016/S0140-6736(05)67352-7. PMID 16168760. 
  2. ^ Directive 2001/37/EC of the European Parliament and of the Council of 5 June 2001 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco products - Commission statement
  3. ^ Gartner CE, Hall WD, Vos T, Bertram MY, Wallace AL, Lim SS (June 2007). "Assessment of Swedish snus for tobacco harm reduction: an epidemiological modelling study". Lancet 369 (9578): 2010–4. doi:10.1016/S0140-6736(07)60677-1. PMID 17498798. 
  4. ^ McKee M, Gilmore A (October 2007). "Swedish snus for tobacco harm reduction". Lancet 370 (9594): 1206; author reply 1206–7. doi:10.1016/S0140-6736(07)61530-X. PMID 17920913. http://www.thelancet.com/journals/lancet/article/PIIS014067360761530X/fulltext. 
  5. ^ Lambe M (October 2007). "Swedish snus for tobacco harm reduction". Lancet 370 (9594): 1206; author reply 1206–7. doi:10.1016/S0140-6736(07)61531-1. PMID 17920911. http://www.thelancet.com/journals/lancet/article/PIIS0140673607615311/fulltext. 
  6. ^ Rivenson A, Hoffmann D, Prokopczyk B, Amin S, Hecht SS (01 December 1988). "Induction of lung and exocrine pancreas tumors in F344 rats by tobacco-specific and Areca-derived N-nitrosamines". Cancer Res. 48 (23): 6912–7. PMID 3180100. http://cancerres.aacrjournals.org/cgi/pmidlookup?view=long&pmid=3180100. 
  7. ^ Smokeless Tobacco, Swedish Snus, and Pancreatic Cancer
  8. ^ Luo J, Ye W, Zendehdel K, et al (June 2007). "Oral use of Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in male construction workers: a retrospective cohort study". Lancet 369 (9578): 2015–20. doi:10.1016/S0140-6736(07)60678-3. PMID 17498797. 
  9. ^ "Use Of Swedish 'Snus' Is Linked To A Doubled Risk Of Pancreatic Cancer". Science Daily. May 11, 2007. http://www.sciencedaily.com/releases/2007/05/070510095314.htm. 
  10. ^ "Swedish Snus Much Safer Than Smoking But Linked To Pancreatic Cancer". Medical News Today. 10 May 2007. http://www.medicalnewstoday.com/articles/70389.php+. 
  11. ^ "Snus och blodtryck". Läkartidningen. 2008-11-21. http://www.lakartidningen.se/07engine.php?articleId=1081. 

[edit] Published peer-reviewed studies

[edit] Cardiovascular diseases

[edit] Diabetes

  • Eliasson M, Asplund K, Nasic S, Rodu B (August 2004). "Influence of smoking and snus on the prevalence and incidence of type 2 diabetes amongst men: the northern Sweden MONICA study". J. Intern. Med. 256 (2): 101–10. doi:10.1111/j.1365-2796.2004.01344.x. PMID 15257722. 

[edit] Cancer

  • Roosaar A, Johansson AL, Sandborgh-Englund G, Axéll T, Nyrén O (July 2008). "Cancer and mortality among users and nonusers of snus". Int. J. Cancer 123 (1): 168–73. doi:10.1002/ijc.23469. PMID 18412245. 

[edit] Smoking cessation

[edit] Medical community discussions and reports

[edit] General media articles

[edit] External links

Sister project Wikimedia Commons has media related to: Snus

[edit] Tobacco Industry-sponsored discussion forums

[edit] Articles

[edit] Non-medical blogs and commentary

Retrieved from "http://en.wikipedia.org/wiki/Snus"
Personal tools