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Recently, governments in developed countries have been trying to reduce smoking. In Sweden, perhaps due to these efforts or because of the cold climate (because it's impossible to smoke outside in winter at -30 Celsius), it is difficult to find a smoker. Instead, many Swedes use snus. The most popular type is "portion snus" (moist tobacco in a small pouch held under the lip).

Both of them are harmful in different ways but I wonder, which one is more harmful? Is there any research about this?

Notes

  • The snus is illegal in European Union, except Norway and Sweden, which suggests it may be more harmful. In the EU countries, cigarettes are legal but they create smoke that affects the lungs and cause lung cancer.

  • All the affects of snus are still not clear, but causes mouth, tongue and pancreatic cancer. It also allows nicotine and other chemicals (e.g. salt crystals, E1520, E500) to flow directly to your salivary & your circulatory system.

  • Snus is consumed for a period of around an hour, but a cigarette lasts at most 5 minutes.

snusing vs smoking

Sklivvz
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msdundar
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    1) The fact that snus is illegal doesn't say anything to me about "destructiveness." 2) Nicotine, itself, is not "destructive" as far as I know (commenting based on your chart -- this purely measures nicotine blood levels). So... this question should be about which delivery method is most harmful. This is quite related to: ["Is nicotine a relatively safe substance?"](http://skeptics.stackexchange.com/questions/4875/is-nicotine-a-relatively-safe-substance) – Hendy Sep 14 '11 at 21:56
  • Where did you find that diagram? Please add a reference to it. (Note: I made some significant edits in an attempt to provide some structure to the post and focus on the key question being asked. – Oddthinking Oct 04 '11 at 11:48
  • According to the [FAQ](http://skeptics.stackexchange.com/faq#questions), Skeptics.SE is for researching the evidence behind the claims you hear or read. Now that I have edited it, this question doesn't appear to have any doubtful claims to investigate. Does anyone actually claim that snus is less harmful? If not, this is out of scope for Skeptics.SE. – Oddthinking Oct 04 '11 at 11:51
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    @Odd: the claim is definitely being made. Swedish health council makes that exact claim on their website (in a page about quitting cigarettes and snus), alas without further qualifications. I reckon it's probably the prevailing notion among Swedes, presumably because it doesn't cause lung cancer. Also, from Wikipedia: "Around 2005 several reports, partially funded by the snus industry, pointed to the fact that no carcinogenic effects could be attributed to Nordic snus and this resulted in the removal of the warning label that claimed snus could cause cancer. – David Hedlund Oct 04 '11 at 12:20
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    ... It was replaced with the more vague label 'May 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." – David Hedlund Oct 04 '11 at 12:20
  • @DavidHedlund, that's quite remarkable. Thank you. I lived in Sweden briefly a long, long time ago, and at the time it seemed common knowledge amongst the snus-users I spoke to that snus caused cancer, but that it was more likely to be cancer of the gums than cancer of the lungs, and was consequently easier to treat/less life threatening. – Oddthinking Oct 04 '11 at 14:34
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    @Odd: while pancreatic cancer stands, the research you're referring to with regards to gum cancer explicitly says "We were unable to confirm any excess of oral ... cancer in snus users." And it is my understanding that this complies with other recent studies. Even so, if it were proven that snus was just as cancerogenic as smoking, only creating a less life threatening type of cancer, I would be inclined to argue that that *did* mean it was less dangerous than smoking. – David Hedlund Oct 04 '11 at 19:47
  • @msdundar (because it's impossible to smoke outside in winter at -30 Celsius) . Not impossible. People do that. Although -30 Celcius is quite unusual to have effect on any large part of the Swedish population as high North is very sparsely populated. – ghellquist Jun 09 '18 at 14:21
  • @msdundar Snus was illegal in the EU countries before Sweden joined. Sweden negotiated a specific exception only valid in Sweden due to cultural and historical reason. Basically not having the exception would tilt the opinion far enough to hinder the membership. Incidentally, Norway is not part of EU. – ghellquist Jun 09 '18 at 14:25

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First of all, smoking statistics in Sweden has followed a trend very similar to that of the rest of the world. I do not think that there is reason to assume that climate is a factor here, and I wouldn't even say that there's much of a difference to be explained in the first place.

Tobacco consumption
enter image description here *OECD

Second, as Hendy points out in comments, the legalization of different substances has little relation to their relative health effects. That is rather a question of policy, and a general trend is often that you seek to criminalize harmful substances if possible, but make exceptions where it is shown or assumed that the implications of smuggling etc would be worse than the direct health effect. However, there are other ways to approach the problem as well, and this is not the forum for political discourse, so I shan't dwell on that beyond having pointed out that this is not a good indication of the health effect of a product.

Now, as far as the actual health implications of snus are concerned:

  • Unlike smoking, snus isn't fire-cured, and as such, doesn't have the cancerogenic effect that you otherwise see due to anaerobic combustion.
  • Unlike smoking, snus isn't inhaled, and as such, does not affect the lungs.
  • Research has shown that snus consumption increases your risk of pancreatic cancer (article in Swedish)
  • Excessive consumption appears to negatively affect cholesterol levels.

The ailments are different, and it is hard to compare different ills across the board. The relative harm is still being debated, but official Swedish government health recommendations currently cite the health implications of snus as less than those of smoking, while still pointing out that both are detrimental to your health (source in Swedish, again).

David Hedlund
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  • Please [provide some references](http://meta.skeptics.stackexchange.com/q/5) to support your claims. Particularly the source of the table, and the claim that without fire-curing/anaerobic combustion, there is a greater carcinogenic effect, and that snus affects cholesterol levels. – Oddthinking Oct 04 '11 at 11:36
  • With 14% of adults smoking daily, it shouldn't be "difficult to find a smoker"! – Oddthinking Oct 04 '11 at 11:52
  • @Odd: I agree, it isn't difficult at all. The source for the table is already given. I'll have a look for further sources re: the other stuff. – David Hedlund Oct 04 '11 at 12:05
  • Sorry if I am being obtuse, but I can't see where the table is from. – Oddthinking Oct 04 '11 at 14:31
  • @Oddthinking: I think he means "OECD". I agree that a link would be convenient. – Jonas Oct 04 '11 at 15:19
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    @Odd: OECD features a *huge* stats database, and I queried their tool for that specific piece of data. As such, that particular view has no URL to which I can point you (well at least I haven't been able to extract such an URL from the tool). I made the judgement that a reference to OECD was enough to point to the source of the data, but I've edited now, by adding a link as far as I was able to link. You'll still have to meddle with it manually to get that exact view, though. – David Hedlund Oct 04 '11 at 19:42
  • Sorry, @David: I associated OECD with a treaty of governments, not a stats database. I am now treading carefully around that site, because I can see it becoming a huge time sink! – Oddthinking Oct 05 '11 at 08:01