Smoking Bans

Snus Beats the Pharmaceutical Competition in Norway


A study recently published online by the journal Nicotine & Tobacco Research finds that switching to snus (Swedish-style oral snuff) is by far the most popular method for quitting smoking in Norway. Furthermore, it is much more effective than using nicotine replacement products sold by pharmaceutical companies. Examining survey responses from about 1,800 current cigarette smokers and about 1,800 former smokers, researchers led by Karl Erik Lund of the Norwegian Institute for Alcohol and Drug Research found that nearly one-third had used snus in their last quit attempt. They were almost three times as likely to have succeeded as the smokers who used the next most popular method, nicotine gum (used by 18 percent of the respondents). The only method that looked more effective than snus was varenicline (sold in the U.S. as Chantix), a prescription drug that is designed to block nicotine's psychoactive effects (and that now carries a daunting FDA warning). Measured by abstinence rates, varenicline was about five times as effective as nicotine gum, but it was used by only 1 percent of the respondents.

Lund and his co-authors speculate that snus—which is banned in most of the E.U. but available in Norway, Sweden, and the U.S.—is more popular and more effective than the pharmaceutical products because "the nicotine dose is almost the same as for cigarettes," because snus "tastes of tobacco and thus has a sensory effect that medicinal nicotine products perhaps lack," and because "the choice of brand, aesthetic rituals of use, and visibility can represent social positioning and self presentation." In short, snus is a closer substitute for cigarettes. Not surprisingly, people who quit smoking by switching to snus are also more likely to continue using the substitute than people who quit with nicotice replacement products. But since the hazards posed by snus are tiny compared to the hazards posed by cigarettes, the health benefit is undeniable—unless you are one of the many anti-smoking activists and public health officials who continue to deny or obscure this truth because you're afraid of what consumers will do with the information.

"In light of all the available evidence," two prominent American tobacco researchers concluded in 2007, "the banning or exaggerated opposition to snus in cigarette-rife environments is not sound public-health policy." Now that the Food and Drug Administration is in charge of regulating tobacco products, it will be making decisions that determine the extent to which snus can compete not only with cigarettes but with pharmaceutical products such as nicotine gum. If it really is guided by science and by public health principles, it will allow snus to be marketed as a safer alternative to cigarettes, and it won't try to suppress information like the results of this study. But I wouldn't bet on it.

Addendum: A commenter claims "the heart is still at just as great a risk with snus as it is with cigarettes." This is just the sort of misinformation that snus alarmists tend to foster. While some research has indicated a link between snus and heart disease, the level of risk found in those studies is substantially lower than the risk associated with cigarette smoking. More-recent research suggests the use of snus does not measurably raise the risk of heart disease: A 2009 study reported in the Journal of Internal Medicine found "there was no association between use of snus and risk for cardiovascular disease." In any case, there is no denying that the overall hazard posed by snus is far lower than the hazard posed by cigarettes. A 2007 Lancet study found "there was little difference in health-adjusted life expectancy between smokers who quit all tobacco and smokers who switch to snus." The authors of the study discussed in this post note that "nicotine uptake from snus instead of from cigarettes has the potential for reducing harm by at least 90%."

[Thanks to Bill Godshall for the tip.]

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  1. So basically Snus = Methadone.

  2. Snus is a safe alternative to cigarettes only for the lungs. The heart is still at just as great a risk with snus as it is with cogarettes, but libertarian hack propagandists don’t have hearts anyway, so snus away, Jacob

    1. This:

      The heart is still at just as great a risk with snus as it is with cogarettes [sic]

      does not refute this:

      But since the hazards posed by snus are tiny compared to the hazards posed by cigarettes,

      1. Placing a “sic” in someone’s quote is much more satisfying/insulting than mercilessly jobbing them.

    2. Snus also eliminates the second hand smoke risk.

      It is certainly better for your health but not perfect.

      1. Snus also eliminates the second hand smoke risk.

        [citation needed]

        1. Uhh… no smoke.

          1. Not to put words in his keyboard, but I think RCD’s very cogent point is that the premise of seconhandsmoke risk is scientifically questionable.

            1. secondhand smoke, even

            2. It is questionable, if you mean the risk of second-hand smoke causing cancer. It may never be proven very conclusively, because how do you eliminate all other environmental factors involved? Not only that, but one has to study someone who is willingly put themselves in an environment with a lot of second-hand smoke for literally decades. Kind of hard to do that nowadays.

              However, there are health concerns related to indoor second-hand smoke that are legitimate. It’s bad for people who have allergies to smoke, asthma, etc. It’s bad for kids and the elderly, etc.

            3. Even if the risk is infinitesimal, the risk is still eliminated.

        2. I’ve known a few people who did not smoke, and the type of lung cancer / their lifestyle led to second hand smoke as being considered the main cause.

          Seems that the relationship is not considered all that tenuous, if minimal venting is presumed.

    3. “The heart is still at just as great a risk with snus as it is with cogarettes”

      The only real risks with snus involve things like mouth cancer. And those risks, as mentioned in the article, are not significant.

      The biggest risk to my heart using snus is that it might break after having to endure falsehoods like the ones spread by Max. ;p

      P.S. Note that I did not make fun of the hilarious typo… OOPS! @#$!!

      1. As I understand things, nicotine itself is not terribly healthy for your heart and circulation. It increases blood pressure, is a vasoconstrictor and does some other things I can’t think of right now. I may have some old or misleading information (I hope I am wrong, I love nicotine and am considering taking up snus instead of smoking), but, while certainly much less likely to kill you than smoking, nicotine by itself is still not good for you.

        1. Sorry for all the posts, but I forgot to mention that the risk of mouth cancer, too, is also much greater from smoking than from using snus.

          I think it’s also worth pointing out that there are quite a few possible psychological benefits from nicotine in alleviating things like depression, ADD/ADHD, schizophrenia and even stuff like Parkinson’s disease. It’s of course true that it’s very very addictive, but it’s also true that people consuming nicotine are likely experiencing medicinal benefits as well.

        2. Nicotine has those effects, but smoking produces carbon monoxide, which may be a more important CV risk factor than is the nicotine.

        3. Nicotine has those effects, but smoking produces carbon monoxide, which may be a more important CV risk factor than is the nicotine.

          1. Damn, you beat me to it. Smoking advocates like to tell you how the carbon monoxide in cigarettes is bad for your heart. Therefore snus is better for your heart.

            Yes, nicotine can still cause your heart to work harder, but so can climbing stairs or having sex.

            I thought nicotine still has the risk of toning down your body’s anti-cancer response, but don’t quote me on that. I thought the last thing I read on the subject said pancreatic cancer was about the only risk from snus.

    4. Exactly. Let Jacob snus away. Leave the decision up to him.

    5. As someone that has made three serious, yet unsuccessful attempts at quitting smoking, I welcome anything that has the potential to assist in doing so. Whatever informed decisions I make in regards to this are deeply personal and none of your fucking business. Nice trollin’ there, son.

      1. May I recommend I personally prefer the Gotlandssnus brand.

        1. Argh, yet another post from me… I also wanted to remind snus users to store their snus in the fridge. That not only keeps the tobacco fresh and tasty but also prevents the formation of carcinogenic nitrosamines from forming.

        2. The store affiliated with SnusCentral is pretty good too. Did everyone stock up on Onyx before the PACT Act went into effect?

        3. Thanks. I think I’ll give the domestic (Camel) version a try first just because they’re readily available, but I’ll probably end up ordering some of the real thing later.

          1. I’ve used the Camel snus flavors before and thought they were pretty good, certainly better imo than the Marlboro flavors.

            1. I just came across this…

              “The most important factors in my choosing Swedish snus to replace cigarettes was that Swedish snus is regulalated as a food product, and MOST importantly, it is steam pasturized to eliminate carcinogenic micro-organisms.

              Unlike Swedish, and yes, even Camel snus, Marlboro does NOT steam or heat pasteurize their product. Thus it is no safer than American Chewing tobacco or ‘dip.'”

              Can anyone confirm or deny this?


      2. I’ve never used snus with the intention of fully quitting smoking, but nonetheless with snus it’s rare that I smoke more than three cig.’s a day as opposed to 3/4 of a pack a day before snus.

    6. Max: get down on your knees, apologize for lying, then suck Reason’s cock.

    7. Huh, you got upgraded from troll to commenter.

    8. Max, someone has been telling you stories. This topic has been well-researched.

      “Overall, there was no association between use of snus and risk for cardiovascular disease.”

      Use of snus and risk for cardiovascular disease: results from the Swedish Twin Registry

      Authors: Hansson, J.; Pedersen, N. L.; Galanti, M. R.; Andersson, T.; Ahlbom, A.; Hallqvist, J.; Magnusson, C.

      Source: Journal of Internal Medicine, Volume 265, Number 6, June 2009 , pp. 717-724(8)

      “Huhtasaari and colleagues found an age adjusted OR for myocardial infarction (MI) of 0.89 (95% CI 0.62 to 1.29) for snus use versus no tobacco use, whereas smoking significantly increased risk of an MI (OR 1.87, 95% CI 1.40 to 2.48). In multivariate analyses smoking remained significantly associated with MI, whereas snus use was not.”

      Effect of smokeless tobacco (snus) on smoking and public health in Sweden

      Authors: J Foulds, L Ramstrom, M Burke, K Fagerstrom

      Source: Tobacco Control 2003;12:349?359

  3. Now, we have snus-snus?

    1. I always figured you were into Amazons, JW.

  4. OH wow, who would have thunk it? Thats like totally amazing.

    1. I can’t believe you’re not butter!

  5. (Swedish-style oral snuff)

    Am I the only one who thinks this means there is a type of snuff that you shove in other orifices?

    1. I dunno but a number of times I’ve mistyped snus as “anus.” The “A” and “S” are right next to each other on a QWERTY keyboard.

      I actually accidentally wrote this sentence once in a chat session with a friend…

      “Swedish men have lower cancer rates than other Europeans because they prefer anus.”


  6. In other news, snorting heroin is the best way to quit shooting it. Smoking crack is the best way to stop snorting coke. And eating jelly donuts is the best way to stop eating milkshakes.

    I don’t get it. You’re still hooked on tobacco. Better for the lungs, but no better for your overall health.

    1. You can still OD from snorting heroin. Smoking crack is more addictive–and generally more expensive as a result–than snorting coke. Jelly donuts are probably just as fattening as milkshakes. The examples you gave are poor analogies.

      Pretty much all the health risks of tobacco are from *smoking* it. Therefore, switching to snus *is* better for your overall health.

    2. “but no better for your overall health.”

      Whoops, you’re completely wrong.

      Nice try, fascist.

    3. Well, it might not be good for your overall health, but unless it’s exactly the same risk profile, it’s either better or worse. It seems pretty likely that it’s better.

      You’re hooked on nicotine. Nicotine is addictive, which is bad when it causes you not to drop your habit of inhaling burnt plant matter. If you can’t overcome your addiction, transferring it to a less destructive behavior is better.

      Anti-tobacco people are usually the first people to sneer at Christians for promoting abstinence over safe sex, because they know that while complete abstinence is safest, it’s also unlikely and people should pick the least dangerous way to give in to their urges. How is snus or e-cigs any different?

    4. The health of your lungs isn’t part of your overall health?

  7. I’m currently wearing a nicotine patch on my tummy. I have a pouch of snus in my mouth next to some nicotine gum while drawing on my Ecigarette. I am proud to be a non-smoker.

    1. That image totally reminds me of that Simpsons episodes where Krusty tries the patch and ends up slapping patches over every available inch of his body.

  8. Byline missing.

  9. “With snus there’s no chewing or spitting. Only pure tobacco enjoyment.”

    Mmmm, mmmm. Nothing like the delicious taste of tobacco in a paper pouch.

  10. Max is not a commenter. He is a perl script hooked up to a douche elemental.

  11. The rest of the EU? Norway is not a member of the EU.
    The European Union is NOT synonymous with Europe! It’s a group of countries, but it does not include all of Europe.

  12. I guess the FDA is going to ban Snus because their owners aren’t making money off of it. Snus doesn’t have the sort of dirty-money clout that Big Pharma and the cigarette companies have, so I suppose in the near future the U.S. government is going to make me take up smoking again. For my safety.

    1. yup. you say true i say thank ya.

  13. I learned a lot about snus from an article I read online and it convinced me to make the switch from cigarettes. Everything I have been reading shows me that snus is pretty much harmless because of the way its made. I highly recommend giving the article a read if you want to find out more information about Snus:

  14. I doubt it’s harmless. But, I am sucking a lump of it just the same and not smoking a cigarette, so it seems to be a pretty good deal. The methadone comparison is especially apt. Of course done doesnt leave a big black lump that slowly wants to slide down your teeth (the los). Oh well. And in reference to the pancreatic cancer, the risk is MUCH higher with smoking, so you’re still better off. But its not “towdull abstinuncee!!”, or put out by the pharmaceutical companies so there will be some complaining here and there.

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